Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR.0062268 | CO |
N | 207X00000X | Orthopaedic Surgeon | Q0349 | TX |
N | 207XS0106X | Orthopaedic Hand Surgeon | DR.0062268 | CO |
Y | 207XS0106X | Orthopaedic Hand Surgeon | Q0349 | TX |
NPI | 1023308384 |
---|---|
Provider Name | Dr. Bryan Anthony Reyes |
First Address | Fort Worth, TX 76161-1205 |
Second Address | Fort Worth, TX 76104-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 13/08/2019 |