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1417451030 NPI Number Info

healthcare provider npi status:  active since 03/20/2018

BRIAN DUFFY

Most Relevant Information

Provider Data
NPI Number 1417451030
Provider Name BRIAN DUFFY
Entity Type Individual

Most Important Dates
Provider Enumeration Date 03/20/2018
Last Updated 04/09/2026

Provider Practice Location

1201 FANNIN ST STE 262
HOUSTON
TX
77002-6943
US

Practice Location Phone/Fax
Phone 866-849-0692
Fax  

Provider Mailing Address

PO BOX 211699
EAGAN
MN
55121-3699
US

Mailing Location Phone/Fax
Phone 866-849-0692
Fax  

Authorized Official
Title or Position N/S
Authorized Official Name N/S
Credentials N/S  
Telephone Number N/S
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Detailed Information

NPI Number 1417451030 has the "Individual" type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — BRIAN DUFFY. Records indicate that the provider gender is "Male".

The enumeration date of this NPI Number is 03/20/2018.
NPI Number information was last time updated on 04/09/2026.

The provider is physically located at:

1201 FANNIN ST STE 262
HOUSTON, TX
77002-6943, US

BRIAN DUFFY can be reached at the following phone number(s):

Phone:  866-849-0692
Fax:  

The provider's official mailing address is:

PO BOX 211699
EAGAN, MN
55121-3699, US

The contact numbers associated with the mailing address are:

Phone:  866-849-0692
Fax:  

Scope of Practice (Taxonomy)

# Primary Taxonomy Code Taxonomy Specialty License Number License State
1 Y 207R00000X Internal Medicine Physician T0772 TX
2 N 207R00000X Internal Medicine Physician 53499 AL
3 N 207R00000X Internal Medicine Physician C1-0029319 DE
4 N 207R00000X Internal Medicine Physician 80203 AZ
5 N 207R00000X Internal Medicine Physician MD-26705 HI
6 N 207R00000X Internal Medicine Physician 77156 TN
7 N 207R00000X Internal Medicine Physician 01099404A IN
8 N 207R00000X Internal Medicine Physician CDR.0006624 CO
9 N 207R00000X Internal Medicine Physician 2026-01212 NC
10 N 207R00000X Internal Medicine Physician MD70104739 WA
11 N 207R00000X Internal Medicine Physician 110890 GA
12 N 207R00000X Internal Medicine Physician 14275320-1235 UT
13 N 207R00000X Internal Medicine Physician 47649 OK
14 N 207R00000X Internal Medicine Physician 2026012934 MO
15 N 207R00000X Internal Medicine Physician MD-56655 IA

Reference NPI Information. Full Replica of the CMS (NPPES) NPI Record

Field Name Field Value
NPI 1417451030
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) DUFFY
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name BRIAN
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address PO BOX 211699
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name EAGAN
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name MN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 55121-3699
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 866-849-0692
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider First Line Business Practice Location Address 1201 FANNIN ST STE 262
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name HOUSTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name TX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 77002-6943
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 866-849-0692
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date 03/20/2018
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 04/09/2026
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 207R00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 Internal Medicine Physician
Healthcare Provider Taxonomy #1
Provider License Number 1 53499
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 AL
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2 207R00000X
Healthcare Provider Taxonomy Code #2
Healthcare Provider Taxonomy 2 Internal Medicine Physician
Healthcare Provider Taxonomy #2
Provider License Number 2 C1-0029319
Provider License Number #2
Provider License Number State Code 2 DE
Provider License Number State Code #2
Healthcare Provider Primary Taxonomy Switch 2 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 3 207R00000X
Healthcare Provider Taxonomy Code #3
Healthcare Provider Taxonomy 3 Internal Medicine Physician
Healthcare Provider Taxonomy #3
Provider License Number 3 T0772
Provider License Number #3
Provider License Number State Code 3 TX
Provider License Number State Code #3
Healthcare Provider Primary Taxonomy Switch 3 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 4 207R00000X
Healthcare Provider Taxonomy Code #4
Healthcare Provider Taxonomy 4 Internal Medicine Physician
Healthcare Provider Taxonomy #4
Provider License Number 4 80203
Provider License Number #4
Provider License Number State Code 4 AZ
Provider License Number State Code #4
Healthcare Provider Primary Taxonomy Switch 4 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 5 207R00000X
Healthcare Provider Taxonomy Code #5
Healthcare Provider Taxonomy 5 Internal Medicine Physician
Healthcare Provider Taxonomy #5
Provider License Number 5 MD-26705
Provider License Number #5
Provider License Number State Code 5 HI
Provider License Number State Code #5
Healthcare Provider Primary Taxonomy Switch 5 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 6 207R00000X
Healthcare Provider Taxonomy Code #6
Healthcare Provider Taxonomy 6 Internal Medicine Physician
Healthcare Provider Taxonomy #6
Provider License Number 6 77156
Provider License Number #6
Provider License Number State Code 6 TN
Provider License Number State Code #6
Healthcare Provider Primary Taxonomy Switch 6 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 7 207R00000X
Healthcare Provider Taxonomy Code #7
Healthcare Provider Taxonomy 7 Internal Medicine Physician
Healthcare Provider Taxonomy #7
Provider License Number 7 01099404A
Provider License Number #7
Provider License Number State Code 7 IN
Provider License Number State Code #7
Healthcare Provider Primary Taxonomy Switch 7 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 8 207R00000X
Healthcare Provider Taxonomy Code #8
Healthcare Provider Taxonomy 8 Internal Medicine Physician
Healthcare Provider Taxonomy #8
Provider License Number 8 CDR.0006624
Provider License Number #8
Provider License Number State Code 8 CO
Provider License Number State Code #8
Healthcare Provider Primary Taxonomy Switch 8 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 9 207R00000X
Healthcare Provider Taxonomy Code #9
Healthcare Provider Taxonomy 9 Internal Medicine Physician
Healthcare Provider Taxonomy #9
Provider License Number 9 2026-01212
Provider License Number #9
Provider License Number State Code 9 NC
Provider License Number State Code #9
Healthcare Provider Primary Taxonomy Switch 9 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 10 207R00000X
Healthcare Provider Taxonomy Code #10
Healthcare Provider Taxonomy 10 Internal Medicine Physician
Healthcare Provider Taxonomy #10
Provider License Number 10 MD70104739
Provider License Number #10
Provider License Number State Code 10 WA
Provider License Number State Code #10
Healthcare Provider Primary Taxonomy Switch 10 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 11 207R00000X
Healthcare Provider Taxonomy Code #11
Healthcare Provider Taxonomy 11 Internal Medicine Physician
Healthcare Provider Taxonomy #11
Provider License Number 11 110890
Provider License Number #11
Provider License Number State Code 11 GA
Provider License Number State Code #11
Healthcare Provider Primary Taxonomy Switch 11 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 12 207R00000X
Healthcare Provider Taxonomy Code #12
Healthcare Provider Taxonomy 12 Internal Medicine Physician
Healthcare Provider Taxonomy #12
Provider License Number 12 14275320-1235
Provider License Number #12
Provider License Number State Code 12 UT
Provider License Number State Code #12
Healthcare Provider Primary Taxonomy Switch 12 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 13 207R00000X
Healthcare Provider Taxonomy Code #13
Healthcare Provider Taxonomy 13 Internal Medicine Physician
Healthcare Provider Taxonomy #13
Provider License Number 13 47649
Provider License Number #13
Provider License Number State Code 13 OK
Provider License Number State Code #13
Healthcare Provider Primary Taxonomy Switch 13 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 14 207R00000X
Healthcare Provider Taxonomy Code #14
Healthcare Provider Taxonomy 14 Internal Medicine Physician
Healthcare Provider Taxonomy #14
Provider License Number 14 2026012934
Provider License Number #14
Provider License Number State Code 14 MO
Provider License Number State Code #14
Healthcare Provider Primary Taxonomy Switch 14 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 15 207R00000X
Healthcare Provider Taxonomy Code #15
Healthcare Provider Taxonomy 15 Internal Medicine Physician
Healthcare Provider Taxonomy #15
Provider License Number 15 MD-56655
Provider License Number #15
Provider License Number State Code 15 IA
Provider License Number State Code #15
Healthcare Provider Primary Taxonomy Switch 15 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Certification Date 04/09/2026
Certification Date

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