Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 6074 | TX |
N | 111NN0400X | Neurology | 6074 | TX |
N | 111NN1001X | Nutrition | 6074 | TX |
Y | 363L00000X | Nurse Practitioner | 776192 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 776192 | TX |
N | 363LP2300X | Nurse Practitioner - Primary Care | 776192 | TX |
NPI | 1073614046 |
---|---|
Provider Name | Dr. Bryan C Hasse |
First Address | Houston, TX 77227-7803 |
Second Address | Houston, TX 77027-7313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U41967 | (02) |