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NPI Code Detail

MEDICARE: MR. BRYANT FITZMORRIS PTA

MEDICARE:  MR. BRYANT  FITZMORRIS  PTA
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
1208100000XPhysical Medicine & Rehabilitation Physician2020947TX

General Provider Information

NPI Number : 1598533614
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYANT FITZMORRIS PTA
Provider Business Mailing Address
First Line : 10111 BRANTLEY BND
Second Line :
City : AUSTIN
State : TX
Zip : 78748-1211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13150 FOUR STAR BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78737-1020
Country : US
Telephone Number : 512-738-6524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2023
Last Update Date : 12/18/2023

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Directions to “ MR. BRYANT FITZMORRIS PTA” Practice Location

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