Individual provider Active NPI

Brandon Richard Harthan, PA-C

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1649715434
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18914 Issued in TX
Practice address
7211 Preston Rd Ste 1200
Plano, TX 75024-0238
Phone
(469) 303-3000
Fax
(469) 303-4510
NPI assigned
Jan 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096004193 IL
Physician Assistant 363A00000X 333701 LA
Physician Assistant 363A00000X PA18914 TX Primary

Addresses

Primary practice location

7211 Preston Rd Ste 1200
Plano, TX 75024-0238

Mailing address

7211 Preston Rd Ste 1200
Plano, TX 75024-0238
Phone (469) 303-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230623001587 LA Practitioner - Physician Assistant 4587022595 Reassigns benefits to 2 organizations
I20250415002362 TX Practitioner - Physician Assistant 4587022595 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
096004193ILMDAthletic Trainer
333701LAMDPhysician Assistant
PA18914TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc CurrentSince Apr 10, 2025 Accepting new patients
Bone & Joint Clinic LLC CurrentSince Jul 1, 2024 Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

2600 Belle Chasse Hwy
Ste I
Terrytown, LA 70056
Phone (504) 391-7670

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7211 Preston Rd
Ste 2100
Plano, TX 75024
Phone (469) 303-0104

7211 Preston Rd
Ste 1200
Plano, TX 75024
Phone (469) 303-3000

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

1300 Childrens Way
Ste 130
Prosper, TX 75078
Phone (469) 303-3000

Organizations & group practices 5

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1649715434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 PRESTON RD STE 1200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750240238",
            "telephone_number": "469-303-3000",
            "fax_number": "469-303-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 PRESTON RD STE 1200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750240238",
            "telephone_number": "469-303-3000",
            "fax_number": "469-303-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTHAN",
        "first_name": "BRANDON",
        "middle_name": "RICHARD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096004193",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "333701",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.