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1164682357
BRANDON TRIMONE MODKINS
HOUSTON, TX
NPI
1164682357
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
305R00000X Preferred Provider Organization
(Licence: TX 04799775)
Enumeration Date
2008-06-11
Last Update Date
2008-06-11
Business Address
-- BRANDON TRIMONE MODKINS
17207 KENDALL RIDGE LN
HOUSTON, TX 77095-5200
Phone number: 281-859-9793
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Mailing Address
-- BRANDON TRIMONE MODKINS
17207 KENDALL RIDGE LN
HOUSTON, TX 77095-5200
Phone number: 281-859-9793
Copy
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