Provider Demographics
NPI:1306159652
Name:GRIFFIN, BRIAN MICHAEL (DC,FNP-C)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DC,FNP-C
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:MICHAEL
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:5508 PARKCREST DR STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4908
Mailing Address - Country:US
Mailing Address - Phone:512-293-6822
Mailing Address - Fax:512-532-0930
Practice Address - Street 1:5508 PARKCREST DR STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4908
Practice Address - Country:US
Practice Address - Phone:512-293-6822
Practice Address - Fax:512-532-0930
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11402111N00000X
TXAP125864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor