Provider Demographics
NPI:1053660449
Name:HOWARD, BRIAN A (CST, CSFA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:HOWARD
Suffix:
Gender:M
Credentials:CST, CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10511 CAMELOT DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2960
Mailing Address - Country:US
Mailing Address - Phone:214-680-0767
Mailing Address - Fax:972-403-7744
Practice Address - Street 1:10511 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-2960
Practice Address - Country:US
Practice Address - Phone:214-680-0767
Practice Address - Fax:972-403-7744
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134424246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant