Provider Demographics
NPI:1346852373
Name:REYNOLDS, BRIANNA N (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:N
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7575 KIRBY DR APT 2416
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4451
Mailing Address - Country:US
Mailing Address - Phone:817-888-0938
Mailing Address - Fax:
Practice Address - Street 1:2535 LONE STAR DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-6313
Practice Address - Country:US
Practice Address - Phone:713-783-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1331433225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist