MEDICARE: BRYANT IRVIN HEALTH SERVICES INC

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	332S00000X	Hearing Aid Equipment		TX

General Provider Information

NPI Number	:	1750729935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYANT IRVIN HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	510 E HWY 377
Second Line	:
City	:	GRANBURY
State	:	TX
Zip	:	76048-2556
Country	:	US
Telephone Number	:	817-579-2660
Fax Number	:	817-579-2663

Provider Business Practice Location Address
First Line	:	4601 BRYANT IRVIN RD
Second Line	:	121
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3688
Country	:	US
Telephone Number	:	817-346-7771
Fax Number	:	817-346-7783

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. TERESA POOL
Credential	:
Telephone Number	:	817-579-2660

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	06/07/2016

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