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General NPI Number Information
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NPI Number | 1578247805
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Entity Type | Organization
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Legal Business Name | BRYAN TEXAS PRIMARY CLINIC PLLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 3201 UNIVERSITY DR E STE 345
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City | BRYAN
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State | TX
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Zip | 77802-3484
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Country | US
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Telephone | 979-776-2715
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Fax | 979-776-9502
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Provider Business Mailing Address
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Address Line | 3201 UNIVERSITY DR E STE 345
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City | BRYAN
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State | TX
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Zip | 77802-3484
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Country | US
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Telephone | 979-776-2715
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Fax | 979-776-9502
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Authorized Official
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Title or Position | OWNER
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Name | JINNY NARULA
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Credential |
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Telephone | 979-776-2715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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