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General NPI Number Information
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NPI Number | 1740695824
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Entity Type | Individual
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Provider Name | BRYAN BOURLAND D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 301 UTICA AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-3111
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Country | US
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Telephone | 806-797-4985
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Fax | 806-792-8588
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Provider Business Mailing Address
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Address Line | 301 UTICA AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-3111
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Country | US
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Telephone | 806-797-4985
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Fax | 806-792-8588
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 5101021223
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | S7395
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | S7395
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License Number State | TX
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