Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | L4872 | TX |
NPI | 1396705463 |
---|---|
Provider Name | William P. Bryant |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76502-1814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1538365-03 | (05) | TX |
1538365-04 | CSHCN (01) | TX |
370022575 | RR/MEDICARE (01) | TX |
8G5398 | BLUE SHIELD (01) | TX |
F45572 | (02) | TX |