Provider Demographics
NPI:1093700478
Name:DUNN, BRYAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:M
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1201 S MAIN ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2833
Mailing Address - Country:US
Mailing Address - Phone:830-815-1081
Mailing Address - Fax:830-815-1082
Practice Address - Street 1:1201 S MAIN ST
Practice Address - Street 2:SUITE 118
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2833
Practice Address - Country:US
Practice Address - Phone:830-815-1081
Practice Address - Fax:830-815-1082
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2012-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9004207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF53193Medicare UPIN