Provider Demographics
NPI:1104347434
Name:BRYANT, KAROL FERNANDA (DDS)
Entity type:Individual
Prefix:DR
First Name:KAROL
Middle Name:FERNANDA
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8226 MISTY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2912
Mailing Address - Country:US
Mailing Address - Phone:832-577-1586
Mailing Address - Fax:
Practice Address - Street 1:110 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3015
Practice Address - Country:US
Practice Address - Phone:936-231-8705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX370851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry