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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043284128 NPPES
Texas Other 0052ET BCBS
Texas MEDICAID 113601203 BCBS
Texas Other 5675166 BCBS

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