Bryan, Michael Dennis
Bryan, Michael Dennis is an sole proprietor health care provider with primary practice located at 660 W Southlake Blvd Suite 100, Southlake TX 76092-6003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Bryan, Michael Dennis can be contacted via phone (817) 416-9731.Contact Information
Primary practice address
660 W Southlake Blvd Suite 100
Southlake TX 76092-6003
Phone: (817) 416-9731
Fax: (817) 416-9751
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | J1503 | Texas |
Profile Details
| NPI number | 1043284128 |
|---|---|
| LBN Legal business name | Bryan, Michael Dennis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Jul 9th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043284128 | NPPES |
| Texas | Other | 0052ET | BCBS |
| Texas | MEDICAID | 113601203 | BCBS |
| Texas | Other | 5675166 | BCBS |
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