Provider Demographics
NPI:1760559744
Name:BRYSON, NEIL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:A
Last Name:BRYSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 N MAXWELL
Mailing Address - Street 2:
Mailing Address - City:TULIA
Mailing Address - State:TX
Mailing Address - Zip Code:79088
Mailing Address - Country:US
Mailing Address - Phone:806-995-4191
Mailing Address - Fax:806-995-4891
Practice Address - Street 1:229 N MAXWELL
Practice Address - Street 2:
Practice Address - City:TULIA
Practice Address - State:TX
Practice Address - Zip Code:79088
Practice Address - Country:US
Practice Address - Phone:806-995-4191
Practice Address - Fax:806-995-4891
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist