Provider Demographics
NPI:1164419537
Name:BRYANT, RICHARD SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SCOTT
Last Name:BRYANT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2805 PRINCE GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2047
Mailing Address - Country:US
Mailing Address - Phone:972-224-9090
Mailing Address - Fax:972-224-9098
Practice Address - Street 1:1014 E WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4914
Practice Address - Country:US
Practice Address - Phone:214-550-2330
Practice Address - Fax:214-550-2331
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2023-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL9636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I22934Medicare UPIN
8C9979Medicare PIN