Provider Demographics
NPI:1043247208
Name:BRYAN, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BRYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-3470
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 2600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4227207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610197302 FANNINOtherUS DEPT OF LABOR
TXP01070469OtherRR MEDICARE
TXP01253341OtherMEDICARE RR
601771109OtherUS DEPT OF LABOR
616771101OtherUS DEPT OF LABOR
TX1043247208Medicaid
TX610197301 CENTERFIELOtherUS DEPT OF LABOR
616771110OtherUS DEPT OF LABOR
TX8S9713OtherBCBS
TX135711309Medicaid
616771105OtherUS DEPT OF LABOR
TXC13888Medicare UPIN
TX8D8823Medicare PIN
TXTXB151107Medicare PIN
TX610197302 FANNINOtherUS DEPT OF LABOR
TX8J0625Medicare PIN