Provider Demographics
NPI:1235500802
Name:YUNCKER, BRYAN RANDOLPH (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:RANDOLPH
Last Name:YUNCKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:110 VINTAGE PARK BLVD
Practice Address - Street 2:SUITE D, BUILDING J
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4047
Practice Address - Country:US
Practice Address - Phone:281-251-3531
Practice Address - Fax:877-688-2225
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor