Kirk, Bryan Edward

Kirk, Bryan Edward is an sole proprietor health care provider with primary practice located at 1708 Dayton Ave , Wichita Falls TX 76301-6110. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Kirk, Bryan Edward can be contacted via phone (940) 322-5477.

Contact Information

Primary practice address
1708 Dayton Ave Wichita Falls TX 76301-6110
Phone: (940) 322-5477
Fax: (940) 720-0018
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP124702 Texas

Profile Details

NPI number 1629497649
LBN Legal business name Kirk, Bryan Edward
Credentials PMH-NP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 8th, 2014
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 1629497649 NPPES
Texas MEDICAID 353600502

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