Individual
R. BRYAN GULLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6421 SARATOGA BLVD, 101, CRP CHRISTI, TX 78414-3479
(361) 992-3873
(361) 992-7328
Mailing address
6421 SARATOGA BLVD, 101, CRP CHRISTI, TX 78414-3479
(361) 992-3873
(361) 992-7328
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12010
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0902611-02
—
TX
Enumeration date
10/10/2006
Last updated
08/23/2011
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