MEDICARE: DR. MEREDITH ANNE BRYARLY M.D.

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
1	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	Q9304	TX
2	2084N0400X	Neurology Physician	Q9304	TX

General Provider Information

NPI Number	:	1194010736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEREDITH ANNE BRYARLY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 660599
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75266-0599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5303 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7708
Country	:	US
Telephone Number	:	214-645-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2011
Last Update Date	:	03/07/2024

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