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Individual

DR. BRYAN C LIPSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
509 W TIDWELL RD, SUITE 314, HOUSTON, TX 77091-4352
(713) 635-6996
(713) 635-6994
Mailing address
509 W TIDWELL RD STE 314, HOUSTON, TX 77091-4354
(731) 635-6996
(713) 635-6994

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J8034
TX
207RI0008X
Hepatology Physician
J8034
TX
207RN0300X
Nephrology Physician
Primary
J8034
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10021896
TX
05
127602408
TX
05
171704301
TX
01
3766622
AETNA
TX
Enumeration date
08/04/2005
Last updated
02/25/2021
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