Provider Demographics
NPI:1124288816
Name:BRYANT, WILLIAM MATTHEW (AUD/F)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MATTHEW
Last Name:BRYANT
Suffix:
Gender:M
Credentials:AUD/F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-742-2164
Mailing Address - Fax:214-827-0162
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 1103
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-742-2164
Practice Address - Fax:214-827-0162
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80132237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter