Provider Demographics
NPI:1730299876
Name:PARRENT, BRYAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:DAVID
Last Name:PARRENT
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 1:2700 E 29TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2507
Mailing Address - Country:US
Mailing Address - Phone:979-776-5631
Mailing Address - Fax:979-776-6184
Practice Address - Street 1:2700 E 29TH ST STE 105
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2507
Practice Address - Country:US
Practice Address - Phone:979-776-5631
Practice Address - Fax:979-776-6184
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0215208600000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S9020OtherBLUE CROSS BLUE SHEILD
TX174379101Medicaid
TX8D6017Medicare ID - Type Unspecified
TX8S9020OtherBLUE CROSS BLUE SHEILD