MEDICARE: DR. ANDREW BRYLOWSKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	H4192	TX
2	2084P0800X	Psychiatry Physician	C50927	CA

General Provider Information

NPI Number	:	1669573309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW BRYLOWSKI M.D.

Provider Business Mailing Address
First Line	:	12300 FORD RD
Second Line	:	SUITE 150
City	:	DALLAS
State	:	TX
Zip	:	75234-7248
Country	:	US
Telephone Number	:	972-241-4472
Fax Number	:

Provider Business Practice Location Address
First Line	:	12300 FORD RD
Second Line	:	SUITE 150
City	:	DALLAS
State	:	TX
Zip	:	75234-7248
Country	:	US
Telephone Number	:	972-241-4472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	01/28/2010

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