Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP143829 | TX |
NPI | 1003426834 |
---|---|
Provider Name | Brandt David Yeamans |
First Address | Baytown, TX 77521-3157 |
Second Address | Baytown, TX 77521-3157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2020 |
Last Update Date | 06/08/2020 |