Active NPI
Brandy Marie Tabor, RDH
- Dental Hygienist
- Georgetown, TX
National Provider Identifier
1578934808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 13525
- Practice address
- 2411 Williams Dr
Suite 111
Georgetown, TX 78628-3271 - Phone
- (512) 864-1445
- Fax
- (512) 864-1447
- NPI assigned
- Oct 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 13525 | TX | Primary |
Addresses
Primary practice location
2411 Williams Dr
Suite 111
Georgetown, TX 78628-3271
Mailing address
2411 Williams Dr
Suite 111
Georgetown, TX 78628-3271
Phone (512) 864-1445
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13525 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1578934808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 WILLIAMS DR",
"address_2": "SUITE 111",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786283271",
"telephone_number": "512-864-1445",
"fax_number": "512-864-1447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2411 WILLIAMS DR",
"address_2": "SUITE 111",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786283271",
"telephone_number": "512-864-1445",
"fax_number": "512-864-1447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABOR",
"first_name": "BRANDY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-13",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TX",
"license": "13525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.