Individual provider Active NPI

Brandon P. Dupre, NP

  • Adult Health Nurse Practitioner
  • Magnolia, TX
National Provider Identifier
1306883426
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP04605 Issued in LA
Practice address
32939 Tamina Rd Ste 104
Magnolia, TX 77354-4177
Phone
(281) 985-5698
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP04605 LA Primary

Addresses

Primary practice location

32939 Tamina Rd Ste 104
Magnolia, TX 77354-4177

Mailing address

32939 Tamina Rd Ste 104
Magnolia, TX 77354-4177
Phone (281) 985-5698

Other identifiers 1

IdentifierTypeStateIssuer
1014311MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1306883426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32939 TAMINA RD STE 104",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773544177",
            "telephone_number": "281-985-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32939 TAMINA RD STE 104",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773544177",
            "telephone_number": "281-985-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPRE",
        "first_name": "BRANDON",
        "middle_name": "P.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "AP04605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014311",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.