MEDICARE: DR. BRYAN J. ALSIP M.D., M.P.H.

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	2083P0901X	Public Health & General Preventive Medicine Physician	0101052840	VA

General Provider Information

NPI Number	:	1366431314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN J. ALSIP M.D., M.P.H.

Provider Business Mailing Address
First Line	:	3851 ROGER BROOKE DR
Second Line	:	MCHE-QD/ CREDENTIALS
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4501
Country	:	US
Telephone Number	:	210-916-2460
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 ROGER BROOKE DR
Second Line	:	MCHE-QD/ CREDENTIALS
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4501
Country	:	US
Telephone Number	:	210-916-2460
Fax Number	:

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. BRYAN J. ALSIP M.D., M.P.H.” Practice Location

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