Basic Information
Provider Information
NPI: 1003281817
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHURE
FirstName: BRANDON
MiddleName: JOSEPH
NamePrefix:  
NameSuffix:  
Credential: ATP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 BARRANCA DR STE 700
Address2:  
City: EL PASO
State: TX
PostalCode: 799355006
CountryCode: US
TelephoneNumber: 9155913130
FaxNumber: 9155913136
Practice Location
Address1: 1111 BARRANCA DR STE 700
Address2:  
City: EL PASO
State: TX
PostalCode: 799355006
CountryCode: US
TelephoneNumber: 9155913130
FaxNumber: 9155913136
Other Information
ProviderEnumerationDate: 12/04/2015
LastUpdateDate: 12/04/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247200000X  Y Technologists, Technicians & Other Technical Service ProvidersTechnician, Other 

No ID Information.


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