Provider Demographics
NPI:1447418256
Name:BRYAN, EDWARD RANSOME IV (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:RANSOME
Last Name:BRYAN
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 E LAMAR BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-7346
Mailing Address - Country:US
Mailing Address - Phone:682-227-6839
Mailing Address - Fax:682-227-6869
Practice Address - Street 1:2000 E LAMAR BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7346
Practice Address - Country:US
Practice Address - Phone:682-227-6839
Practice Address - Fax:682-227-6869
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM8562207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology