Individual
BRYANT CARROLL BOREN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 499-7933
Mailing address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
P4024
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2010
Last updated
06/15/2016
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