Basic Information
| Provider Information | |||||||||
| NPI: | 1851621379 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRANDA | ||||||||
| FirstName: | SUMMER | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11511 SHADOW CREEK PKWY | ||||||||
| Address2: | |||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775847298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134420000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2727 W HOLCOMBE BLVD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770251669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134420000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2010 | ||||||||
| LastUpdateDate: | 06/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD467883 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D86728 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 266668 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 4301116918 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0002X | Q0877 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 207R00000X | Q0877 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 339946101 | 05 | TX | MEDICAID | P01491387 | 01 | TX | RR MEDICARE | OTHER | 339946103 | 05 | TX | MEDICAID | 339946105 | 05 | TX | MEDICAID | 339946106 | 05 | TX | MEDICAID | 339946107 | 05 | TX | MEDICAID | 339946104 | 05 | TX | MEDICAID | 8ER280 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER |