MEDICARE: BRYAN MICHAEL DUFFIN DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	2382	TX

General Provider Information

NPI Number	:	1548654528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYAN MICHAEL DUFFIN DPM

Provider Business Mailing Address
First Line	:	3201 E PRESIDENT GEORGE BUSH HWY STE 106
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-3565
Country	:	US
Telephone Number	:	214-217-3668
Fax Number	:	214-217-3669

Provider Business Practice Location Address
First Line	:	3201 E PRESIDENT GEORGE BUSH HWY STE 106
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-3565
Country	:	US
Telephone Number	:	214-217-3668
Fax Number	:	214-217-3669

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

Provider Enumeration Date	:	03/26/2015
Last Update Date	:	03/12/2026

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