Individual
MS. KATHYANN CYNTHELESE BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSA
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT034925
TX
246ZC0007X
Surgical Assistant
SA00606
TX
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00P07U
BCBS - OLTON SURGICAL SERVICES, LLC
TX
01
—
SA00606
TEXAS MEDICAL BOARD
TX
Enumeration date
01/14/2009
Last updated
10/13/2020
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