Individual
BRYAN WIECK
Active
Individual
BRYAN WIECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J0361
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T02F
BLUE CROSS BLUE SHIELD
TX
05
—
100158970A
—
OK
05
—
115962602
—
TX
01
—
122759
SUPERIOR
TX
01
—
126829100
FIRSTCARE
TX
01
—
128381
MHN
TX
01
—
168446
COMPSYCH
TX
01
—
208776
VALUEOPTIONS
TX
01
—
5674356
FIRST HEALTH/CCN
TX
01
—
5982351
AETNA BEHAVIORAL HEALTH
TX
01
—
MDJ0361
WORKERS COMPENSATION
TX
Enumeration date
07/19/2005
Last updated
02/27/2025
Update your record
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