Organization · NPI-2

Bryan Family Medicine Clinic, PA

Family Medicine · Bryan, TX

NPI number1235193483
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1235193483
Entity type
Organization (NPI-2)
Legal business name
Bryan Family Medicine Clinic, PA
Organization subpart
No
Enumeration date
Apr 14, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine–TXYes

Practice location

2709 Osler Blvd
Bryan, TX 77802-2518

Phone 979-776-2200

Mailing address

2709 Osler Blvd
Bryan, TX 77802-2518

Phone 979-776-2200

Authorized official

Shailesh Dhaduk
President
9797762200

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