Provider Demographics
NPI:1154684645
Name:GENGLER, BRIAN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:GENGLER
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 1:215 OLD HIGHWAY 1187
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0281
Mailing Address - Country:US
Mailing Address - Phone:817-926-2663
Mailing Address - Fax:817-293-8860
Practice Address - Street 1:215 OLD HIGHWAY 1187
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0281
Practice Address - Country:US
Practice Address - Phone:817-926-2663
Practice Address - Fax:817-293-8860
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10044556207X00000X
TXR1755207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery