# BRYAN E KIRK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801264775
- **Authorized official:** MR. BRYAN E KIRK PMH-NP (MANAGING MEMBER)
- **Authorized official phone:** (940) 631-7066

## Contact information

- **Practice address:** 1708 DAYTON AVE, WICHITA FALLS, TX 76301-6110
- **Practice address phone:** (940) 322-5477
- **Practice address fax:** (940) 720-0018
- **Mailing address:** PO BOX 9632, WICHITA FALLS, TX 76308-9562
- **Mailing address phone:** (940) 322-5477
- **Mailing address fax:** (940) 720-0018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 679387 | TX | Yes |

## Other

- **Enumeration date:** 09/09/2015
- **Last updated:** 01/11/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 356827101 | — | TX |