Individual
BRIAN BUMPHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
26229 N CRANES MILL RD, CANYON LAKE, TX 78133-1957
(930) 935-2800
Mailing address
1425 AUSTIN HWY, SAN ANTONIO, TX 78209-4337
(210) 753-1130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
41704171
TX
171M00000X
Case Manager/Care Coordinator
Primary
41704171
TX
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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