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NPI Code Detail

MEDICARE: BRIAN SEAN ISKRA MD

MEDICARE: BRIAN SEAN ISKRA 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
1390200000XStudent in an Organized Health Care Education/Training Program764682TX

General Provider Information

NPI Number : 1164106332
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN SEAN ISKRA MD
Provider Business Mailing Address
First Line : 7734 WEXFORD SQ
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-3923
Country : US
Telephone Number : 347-481-1148
Fax Number :
Provider Business Practice Location Address
First Line : 701 E MARSHALL AVE STE 400
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5595
Country : US
Telephone Number : 903-315-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2023
Last Update Date : 05/11/2026

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