Provider Demographics
NPI:1528682812
Name:BRYCE SAMUEL INDUSTRIES, LLC
Entity type:Organization
Organization Name:BRYCE SAMUEL INDUSTRIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-552-3052
Mailing Address - Street 1:16421 PARALEE CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-3012
Mailing Address - Country:US
Mailing Address - Phone:512-552-3052
Mailing Address - Fax:
Practice Address - Street 1:3620 RANCH ROAD 620 S STE 200
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-6855
Practice Address - Country:US
Practice Address - Phone:512-643-9105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty