Provider Demographics
NPI:1093072571
Name:HISCOX, BRYAN COLLINS (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:COLLINS
Last Name:HISCOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 BRANFORD PL STE 240
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3794
Mailing Address - Country:US
Mailing Address - Phone:281-240-4313
Mailing Address - Fax:281-240-3646
Practice Address - Street 1:7616 BRANFORD PL STE 240
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3794
Practice Address - Country:US
Practice Address - Phone:281-240-4313
Practice Address - Fax:281-240-3646
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA143534207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program