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NPI Code Detail

MEDICARE: BRYAN NOVOSAD MD

MEDICARE: BRYAN NOVOSAD 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
1207Q00000XFamily Medicine PhysicianE8768TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356335517
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN NOVOSAD MD
Provider Business Mailing Address
First Line : 2601 W LAKE HOUSTON PKWY
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-5222
Country : US
Telephone Number : 281-360-7502
Fax Number : 281-360-0587
Provider Business Practice Location Address
First Line : 2601 W LAKE HOUSTON PKWY
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-5222
Country : US
Telephone Number : 281-360-7502
Fax Number : 281-360-0587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 03/08/2011

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Directions to “ BRYAN NOVOSAD MD” Practice Location

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