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NPI Code Detail

MEDICARE: DR. BRIAN MATTHEW DANSHAW D.O.

MEDICARE: DR. BRIAN MATTHEW DANSHAW D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine PhysicianT0761TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1013301894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN MATTHEW DANSHAW D.O.
Provider Business Mailing Address
First Line : 6900 HARRIS PKWY STE 310
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4261
Country : US
Telephone Number : 817-916-4685
Fax Number : 817-769-3718
Provider Business Practice Location Address
First Line : 6900 HARRIS PKWY STE 310
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4261
Country : US
Telephone Number : 817-916-4685
Fax Number : 817-769-3718
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2015
Last Update Date : 10/20/2025

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