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Individual
KIMBERLEY BROOKE BRYANT
Active
Individual
KIMBERLEY BROOKE BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0116015548
VA
207R00000X
Internal Medicine Physician
Primary
M6547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188546902
—
TX
05
—
188546903
—
TX
05
—
188546904
—
TX
01
—
45-2578435-002
TRICARE
TX
01
—
75-2616977-042
TRICARE
TX
01
—
752616977007
TRICARE
TX
01
—
752616977118
TRICARE
TX
01
—
8FD278
BCBS
TX
01
—
8V3856
BCBS
TX
01
—
P00862545
MEDICARE RAILROAD
TX
01
—
P01502424
RAIL ROAD
TX
Enumeration date
03/27/2006
Last updated
10/31/2015
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