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Individual

BRYAN THOMAS ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1601 W 11TH PL, BIG SPRING, TX 79720-4114
(432) 263-1211
Mailing address
1621 UTAH AVE, SAN ANGELO, TX 76904-7188
(325) 812-8320

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP138976
TX
363LF0000X
Family Nurse Practitioner
AP138976
TX

Other

Enumeration date
12/21/2018
Last updated
01/03/2019
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