Provider Demographics
NPI:1568805828
Name:HANUS, BRYAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:DAVID
Last Name:HANUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2933
Mailing Address - Country:US
Mailing Address - Phone:361-887-7000
Mailing Address - Fax:361-531-3185
Practice Address - Street 1:1812 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2933
Practice Address - Country:US
Practice Address - Phone:361-887-7000
Practice Address - Fax:361-561-3185
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2023-01-18
Deactivation Date:2023-01-10
Deactivation Code:
Reactivation Date:2023-01-13
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR04082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program