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Individual

BRYAN T IRVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
940 HESTERS CROSSING, ROUND ROCK, TX 78681-8018
(512) 244-9024
(512) 218-3704
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 421-4489

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2485
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101984602
TX
05
101984603
TX
Enumeration date
07/29/2006
Last updated
01/04/2011
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