Provider Demographics
NPI:1609006675
Name:BRIGHTMAN, BRYON CHRISTOPHER (IDMT)
Entity Type:Individual
Prefix:
First Name:BRYON
Middle Name:CHRISTOPHER
Last Name:BRIGHTMAN
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14502 CRYSTAL CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-5442
Mailing Address - Country:US
Mailing Address - Phone:702-525-6617
Mailing Address - Fax:
Practice Address - Street 1:14502 CRYSTAL CT
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-5442
Practice Address - Country:US
Practice Address - Phone:702-525-6617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians