Brandon James Lang, PA-C

Individual provider Active NPI Medical Physician Assistant · Bandera, TX

NPI 1750150546 · NPPES record last updated Dec 21, 2023

Key facts

NPI
1750150546
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
Practice address
1050 Hwy 16 S
Bandera, TX 78003-4830
Phone
(830) 796-7713
NPI assigned
Dec 21, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240213000579 TX Practitioner - Physician Assistant 6305289711 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TX Yes

Addresses

Primary practice location

1050 Hwy 16 S
Bandera, TX 78003-4830

Mailing address

1050 Hwy 16 S
Bandera, TX 78003-4830
Phone (830) 796-7713

Other providers in Bandera, TX

All providers in Bandera, TX · Medical Physician Assistant in Texas

Sources for this page

Verify at the official NPI Registry.