Provider Demographics
NPI:1073232955
Name:BRYAN, MORGAN CECILY (NP-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:CECILY
Last Name:BRYAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 EGRET LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5801
Mailing Address - Country:US
Mailing Address - Phone:214-679-0633
Mailing Address - Fax:
Practice Address - Street 1:1705 EGRET LN
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5801
Practice Address - Country:US
Practice Address - Phone:214-679-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048502363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner