Individual
CODY BRYAN DU VALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
505 SOUTH JOHN REDDITT DRIVE, LUFKIN, TX 75904
(936) 634-8311
Mailing address
PO BOX 1888, GREENVILLE, TX 75403
(800) 945-2455
(903) 453-2541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J6414
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103617002
—
TX
Enumeration date
05/16/2006
Last updated
05/15/2008
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