Provider Demographics
NPI:1891192464
Name:BARRUS, BRYCE (RESIDENT)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:BARRUS
Suffix:
Gender:M
Credentials:RESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 LOUIS PASTEUR DR STE 160
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4535
Mailing Address - Country:US
Mailing Address - Phone:210-614-9222
Mailing Address - Fax:
Practice Address - Street 1:7220 LOUIS PASTEUR DR STE 160
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4535
Practice Address - Country:US
Practice Address - Phone:210-614-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist