Provider Demographics
NPI:1659372373
Name:BRYANT, JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5610 W RIVER PARK DR
Mailing Address - Street 2:SUITE A.
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7901
Mailing Address - Country:US
Mailing Address - Phone:281-494-8687
Mailing Address - Fax:281-494-5201
Practice Address - Street 1:5610 W RIVER PARK DR
Practice Address - Street 2:SUITE A.
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7901
Practice Address - Country:US
Practice Address - Phone:281-494-8687
Practice Address - Fax:281-494-5201
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7865208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH23567Medicare UPIN