Provider Demographics
NPI:1780631986
Name:KAISER, BRYAN W (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:W
Last Name:KAISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 CONCORD PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6905
Mailing Address - Country:US
Mailing Address - Phone:210-593-1485
Mailing Address - Fax:210-593-1418
Practice Address - Street 1:2829 BABCOCK RD
Practice Address - Street 2:700
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6028
Practice Address - Country:US
Practice Address - Phone:210-593-1485
Practice Address - Fax:210-593-1418
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3914207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00066523OtherRAILROAD MEDICARE
TX151014102Medicaid
TX7851479OtherAETNA
TX5301532OtherCIGNA
TX8K6271OtherBCBS
TX151014102Medicaid
TXP00066523OtherRAILROAD MEDICARE