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General NPI Number Information
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NPI Number | 1295942977
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Entity Type | Individual
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Provider Name | MARIA DIANN BRYANT RPH
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2310 LYNDON B JOHNSON FWY SUITE 100
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City | DALLAS
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State | TX
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Zip | 75234-7335
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Country | US
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Telephone | 972-929-7105
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 TURTLE RIVER CT
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City | FORT WORTH
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State | TX
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Zip | 76137-3739
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Country | US
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Telephone | 817-581-6077
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 31683
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License Number State | TX
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