Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | P5056 | TX |
Y | 208600000X | Surgeon | P5056 | TX |
N | 2086S0122X | Plastic and Reconstructive Surgery | P5056 | TX |
NPI | 1306085535 |
---|---|
Provider Name | Dr. Bryan J Correa |
First Address | Houston, TX 77004-1252 |
Second Address | The Woodlands, TX 77381-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2009 |
Last Update Date | 11/08/2020 |