Provider Demographics
NPI:1346073574
Name:BRYANT FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:BRYANT FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VERONIKA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:940-553-7092
Mailing Address - Street 1:1716 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-4736
Mailing Address - Country:US
Mailing Address - Phone:940-553-7092
Mailing Address - Fax:940-553-7095
Practice Address - Street 1:1716 MAIN ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-4736
Practice Address - Country:US
Practice Address - Phone:940-553-7092
Practice Address - Fax:940-553-7095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center