NPI 1164682357

Brandon Trimone Modkins

Practitioner Preferred Provider Organization Houston, TX

Practice location

Address: 17207 Kendall Ridge Ln, Houston, TX 77095-5200
Phone: (281) 859-9793

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 04799775 (TX)

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Registry record

NPI: 1164682357
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jun 2008
Record last updated: 11 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.