Individual
BRYAN KEITH DEMARIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6750 N MACARTHUR BLVD, SUITE 350, IRVING, TX 75039-2875
(972) 556-1616
(972) 556-1740
Mailing address
6750 N MACARTHUR BLVD, SUITE 350, IRVING, TX 75039-2875
(972) 556-1616
(972) 556-1740
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K9256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042740302
—
TX
05
—
042740303
—
TX
05
—
042740304
—
TX
01
—
042740305
MEDICAID OTHER
TX
Enumeration date
05/28/2006
Last updated
10/23/2019
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