Provider Demographics
NPI:1366948226
Name:BRYANT, AMY RENEE (AGNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:RENEE
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 WEST LOOP N STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1751
Mailing Address - Country:US
Mailing Address - Phone:713-690-1980
Mailing Address - Fax:713-690-1980
Practice Address - Street 1:333 WEST LOOP N STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1751
Practice Address - Country:US
Practice Address - Phone:713-690-1980
Practice Address - Fax:713-690-1980
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137160363LG0600X, 363LA2200X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care