MEDICARE: RONALD BRYANT 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
1	207R00000X	Internal Medicine Physician	L0784	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8A7631	OTHER	TX	BCBS OF TEXAS

General Provider Information

NPI Number	:	1265420970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD BRYANT MD

Provider Business Mailing Address
First Line	:	PO BOX 301189
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77230-1189
Country	:	US
Telephone Number	:	713-521-2221
Fax Number	:	713-521-2221

Provider Business Practice Location Address
First Line	:	2118 OAKDALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7410
Country	:	US
Telephone Number	:	713-521-2221
Fax Number	:

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	01/31/2024

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