Provider Demographics
NPI:1144585019
Name:O'BRYANT HOUSE
Entity Type:Organization
Organization Name:O'BRYANT HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT AND BACK OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-208-4511
Mailing Address - Street 1:7122 TIMBER MOSS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4115
Mailing Address - Country:US
Mailing Address - Phone:281-208-4511
Mailing Address - Fax:
Practice Address - Street 1:7122 TIMBER MOSS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4115
Practice Address - Country:US
Practice Address - Phone:281-208-4511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU23812181OtherCIGNA