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General NPI Number Information
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NPI Number | 1144435637
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Entity Type | Individual
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Provider Name | DR. BRIAN WESLEY BISHOP
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 8550 PLANO RD STE 104
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City | DALLAS
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State | TX
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Zip | 75238-4824
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Country | US
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Telephone | 214-342-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 1409 S. LAMAR ST. #529
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City | DALLAS
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State | TX
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Zip | 75215
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Country | US
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Telephone | 214-205-9097
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22676
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22676
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License Number State | TX
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