Provider Demographics
NPI:1548233968
Name:BRYANT, DAVID PEARCE (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PEARCE
Last Name:BRYANT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 N BECKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1201
Mailing Address - Country:US
Mailing Address - Phone:214-942-5733
Mailing Address - Fax:214-942-6115
Practice Address - Street 1:1441 N BECKLEY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-942-5733
Practice Address - Fax:214-942-6115
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2572207P00000X
LA25833207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA25833OtherMEDICAL LICENSE NUMBER
TXP00362176OtherRR MEDICARE
LA1 04251 0Medicaid
LA1042510Medicaid
TX8G8441OtherMEDICARE
TX190361301Medicaid
TX8U7853OtherBC/BS
TXM2572OtherTEXAS MEDICAL LICENSE
TX8U7853OtherBC/BS