Individual
MR. BRYAN LEE MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1711 DOOLITTLE AVE, FORT WORTH, TX 76127-1133
(817) 782-5913
Mailing address
805 N KELSO AVE, KELSO, WA 98626-4230
(360) 425-2115
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02987
TX
Other
Enumeration date
12/15/2005
Last updated
07/08/2007
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