Provider Demographics
NPI:1235892753
Name:HOYT, BRADY
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:
Last Name:HOYT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2772 GASON AVE
Mailing Address - Street 2:APT. 14113
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226
Mailing Address - Country:US
Mailing Address - Phone:585-260-1738
Mailing Address - Fax:
Practice Address - Street 1:411 N WASHINGTON AVE STE 4000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1776
Practice Address - Country:US
Practice Address - Phone:214-820-7457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6822081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine