Individual provider Active NPI

Brandon Wayne Vidrine, NP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1053540187
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP123619 Issued in TX
Practice address
1635 North Loop W
Houston, TX 77008-1532
Phone
(713) 338-6565
NPI assigned
Jul 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN109960 LA
Family Nurse Practitioner 363LF0000X 835831 TX
Family Nurse Practitioner 363LF0000X AP123619 TX Primary

Addresses

Primary practice location

1635 North Loop W
Houston, TX 77008-1532

Mailing address

909 Frostwood Dr Ste 1.100
Houston, TX 77024-2301
Phone (713) 338-5519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000123 TX Practitioner - Nurse Practitioner 7416003991 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 790-3311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN109960LAMDNurse Practitioner
835831TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA CurrentSince Jul 19, 2023 Accepting new patients
Memorial Hermann Hospital Based Physician Group CurrentSince Jul 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Nurse Practitioner CurrentSince May 16, 2013 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Dec 6, 2024 Accepting new patients
Curana Health of Louisiana LLC Past Accepting new patients
Acs Primary Care Physicians Louisiana PC Nurse Practitioner Past Accepting new patients
Methodist Health Centers Past Accepting new patients
Grosbeak Emergency Physicians LLC Past Accepting new patients
Sulphur Emergency Group LLC Nurse Practitioner Past Accepting new patients

Locations

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

1505 E Winding Way Dr
Ste 112
Friendswood, TX 77546
Phone (281) 993-3860

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

18500 Katy Fwy
Houston, TX 77094
Phone (281) 206-9020

1431 Studemont St
Ste C1
Houston, TX 77007

18220 Tomball Pkwy
Houston, TX 77070
Phone (281) 477-0000

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

23900 Katy Fwy
Katy, TX 77494
Phone (281) 644-7000

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

2555 Gulf Fwy S
#C1100
League City, TX 77573

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

1227 Museum Square Dr
Ste A
Sugar Land, TX 77479
Phone (281) 265-8125

17201 Interstate 45 S
The Woodlands, TX 77385
Phone (936) 270-2000

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

19419 Gulf Fwy
Ste 3
Webster, TX 77598
Phone (281) 316-0885

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1053540187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 FROSTWOOD DR STE 1.100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242301",
            "telephone_number": "713-338-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NORTH LOOP W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081532",
            "telephone_number": "713-338-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "BRANDON",
        "middle_name": "WAYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN109960",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "835831",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP123619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.