Individual
BRYAN SPRUILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00599
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
847N26
BLUE CROSS BLUE SHIELD
TX
01
—
8N3469
BLUESHILED
TX
Enumeration date
08/30/2006
Last updated
06/07/2011
Update your record
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