Individual
BRANDON SCOTT RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 771-8100
Mailing address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-8797
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
745226
—
TX
Enumeration date
04/08/2022
Last updated
04/11/2022
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