Individual
BRIANNA SOUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
909 E SE LOOP 323 STE 360, TYLER, TX 75701-9101
(903) 393-3169
(903) 508-6154
Mailing address
909 E SE LOOP 323 STE 360, TYLER, TX 75701-9101
(903) 393-3169
(903) 508-6154
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2020-00828
NC
2080P0202X
Pediatric Cardiology Physician
Primary
V2279
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020-00828
NORTH CAROLINA MEDICAL BOARD
NC
01
—
V2279
TEXAS MEDICAL BOARD
TX
Enumeration date
03/22/2017
Last updated
06/29/2024
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