Individual
BRIAN D. BIRMINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4916 OVERTON PLZ, FORT WORTH, TX 76109-4415
(888) 804-3000
(817) 334-0235
Mailing address
3921 LOCHRIDGE CT, FORT WORTH, TX 76180-8772
(817) 590-2970
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
629848
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164884202
—
TX
Enumeration date
05/17/2006
Last updated
07/08/2007
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