Provider Demographics
NPI:1073614046
Name:HASSE, BRYAN C (FNP,DC, DACBN,CCN)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:C
Last Name:HASSE
Suffix:
Gender:M
Credentials:FNP,DC, DACBN,CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27803
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77227-7803
Mailing Address - Country:US
Mailing Address - Phone:713-626-2334
Mailing Address - Fax:
Practice Address - Street 1:5222 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3311
Practice Address - Country:US
Practice Address - Phone:713-626-2334
Practice Address - Fax:713-626-2337
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6074111N00000X, 111NN0400X, 111NN1001X
TX776192363L00000X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB146967Medicare PIN
U41967Medicare UPIN