Forsyth, Bruce Lee

Forsyth, Bruce Lee is an individual health care provider with primary practice located at 3700 Cross Park Dr , Bryan TX 77802-4137. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Forsyth, Bruce Lee can be contacted via phone (979) 774-9958.

Contact Information

Primary practice address
3700 Cross Park Dr Bryan TX 77802-4137
Phone: (979) 774-9958
Fax: (979) 774-9978
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT1114031 Texas

Profile Details

NPI number 1992799605
LBN Legal business name Forsyth, Bruce Lee
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Jan 11th, 2017 - about 9 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 1992799605 NPPES
Texas MEDICAID 10061401

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