MEDICARE: BRYAN AUSTIN

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	332B00000X	Durable Medical Equipment & Medical Supplies		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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386770675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYAN AUSTIN

Provider Business Mailing Address
First Line	:	PO BOX 3609
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75106-3609
Country	:	US
Telephone Number	:	214-902-0040
Fax Number	:	214-902-0220

Provider Business Practice Location Address
First Line	:	2639 WALNUT HILL LN
Second Line	:	SUITE#103
City	:	DALLAS
State	:	TX
Zip	:	75229-5640
Country	:	US
Telephone Number	:	214-902-0040
Fax Number	:	214-902-0220

Authorized Official
Title or Position	:	OWNER
Name	:	BRYAN AUSTIN
Credential	:	D.M.E
Telephone Number	:	214-902-0040

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	11/16/2010

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Directions to “BRYAN AUSTIN ” Practice Location

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