Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NP0017X | Pediatric Chiropractor | 9421 | TX |
Y | 111NR0400X | Rehabilitation Chiropractor | 9421 | TX |
NPI | 1649237801 |
---|---|
Provider Name | Dr. Bryan C Mccormick |
First Address | Cedar Hill, TX 75104-2424 |
Second Address | Cedar Hill, TX 75104-2424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 01/04/2013 |