Individual
MR. BRIAN BERNARD LIPSCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1101 S MAIN ST, FORT WORTH, TX 76104-4802
(817) 321-4749
Mailing address
1101 S MAIN ST, FORT WORTH, TX 76104-4802
(817) 321-4749
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
232279
TX
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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