Provider Demographics
NPI:1841306511
Name:MYERS, BRANDON KEITH (PA-C)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:KEITH
Last Name:MYERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2601 CARTWRIGHT RD # D120
Mailing Address - Street 2:ATTN: BRANDON MYERS
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2613
Mailing Address - Country:US
Mailing Address - Phone:281-755-1210
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:SUITE 724B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:832-325-7321
Practice Address - Fax:713-500-5484
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPAO5227363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y4003OtherBCBS
TX8K5504Medicare PIN
TX8Y4003OtherBCBS
AKQ58018Medicare UPIN