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NPI Code Detail

MEDICARE: BRYAN YOUREE MD

MEDICARE:   BRYAN  YOUREE  MD
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
1207RI0200XInfectious Disease PhysicianM4674TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18J8303OTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3M4674OTHERTXTEXAS LICENSE

General Provider Information

NPI Number : 1114014248
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN YOUREE MD
Provider Business Mailing Address
First Line : PO BOX 162464
Second Line :
City : FORT WORTH
State : TX
Zip : 76161-2464
Country : US
Telephone Number : 817-810-9810
Fax Number : 817-810-9815
Provider Business Practice Location Address
First Line : 1025 COLLEGE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3013
Country : US
Telephone Number : 817-810-9810
Fax Number : 817-810-9815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2006
Last Update Date : 11/08/2018

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Directions to “ BRYAN YOUREE MD” Practice Location

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