Provider Demographics
NPI:1649237801
Name:MCCORMICK, BRYAN C (DC,)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:C
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E BELT LINE RD STE 180
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2424
Mailing Address - Country:US
Mailing Address - Phone:469-272-7000
Mailing Address - Fax:469-272-3069
Practice Address - Street 1:950 E BELT LINE RD STE 180
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2424
Practice Address - Country:US
Practice Address - Phone:469-272-7000
Practice Address - Fax:469-272-3069
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9421111NR0400X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor