Provider Demographics
NPI:1346696770
Name:BILBREY, TIMOTHY RYAN (MBA)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:RYAN
Last Name:BILBREY
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 WEISKOPF AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5241
Mailing Address - Country:US
Mailing Address - Phone:888-801-5675
Mailing Address - Fax:877-922-4348
Practice Address - Street 1:6800 WEISKOPF AVE STE 150
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5241
Practice Address - Country:US
Practice Address - Phone:888-801-5675
Practice Address - Fax:877-922-4348
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX812334081171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX812334081OtherTAX ID#