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Individual

WILLIAM L BRYANT

Active
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Individual

WILLIAM L BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2422TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093246902
—
TX
05
—
093246904
—
TX
01
—
410017521
RAIL ROAD MEDICARE
TX
01
—
80627Q
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/26/2006
Last updated
06/22/2015
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