Provider Demographics
NPI:1184115644
Name:COUCH, BRANDON KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:KEITH
Last Name:COUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:225 E SONTERRA BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3886
Mailing Address - Country:US
Mailing Address - Phone:210-614-5100
Mailing Address - Fax:210-614-5103
Practice Address - Street 1:225 E SONTERRA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3886
Practice Address - Country:US
Practice Address - Phone:210-614-5100
Practice Address - Fax:210-614-5103
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV0713207X00000X, 207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program