Provider Demographics
NPI:1346293453
Name:BYRD, WILLIAM BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRIAN
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6100 HARRIS PKWY STE 1240
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4248
Mailing Address - Country:US
Mailing Address - Phone:817-433-5155
Mailing Address - Fax:817-433-5177
Practice Address - Street 1:6100 HARRIS PKWY STE 1240
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4248
Practice Address - Country:US
Practice Address - Phone:817-433-5155
Practice Address - Fax:817-433-5177
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133644810Medicaid
TX0068LMOtherBCBS
TX8C0772Medicare PIN
TX0068LMOtherBCBS