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NPI 1831383694

NPI 1831383694 : BRYAN SCOTT KING L.P.C. : AMARILLO, TX

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General NPI Number Information
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    NPI Number           |    1831383694
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    Entity Type          |    Individual 
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    Provider Name        |    BRYAN SCOTT KING L.P.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/04/2007
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    Last Update Date     |    09/04/2007
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Provider Practice Location Address
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    Address Line         |    129 N ROSEMONT ST 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79106-5213
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    Country              |    US
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    Telephone            |    806-674-3017
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    129 N ROSEMONT ST 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79106-5213
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    Country              |    US
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    Telephone            |    806-674-3017
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    18806
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    License Number State |    TX
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