Individual
BRANDON TARL HAMISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5802 SARATOGA BLVD STE 130, CORPUS CHRISTI, TX 78414-4252
(361) 696-6200
(361) 985-0305
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L9227
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130864507
—
TX
05
—
167840106
—
TX
05
—
167840108
—
TX
01
—
1L5691
MEDICARE
TX
01
—
P02601747
MCRR
TX
Enumeration date
05/23/2006
Last updated
02/28/2024
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