Provider Demographics
NPI:1982632709
Name:BRYANT, PAULA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:LYNN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24727 TOMBALL PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-7877
Mailing Address - Country:US
Mailing Address - Phone:832-659-5695
Mailing Address - Fax:346-414-0044
Practice Address - Street 1:24727 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-7877
Practice Address - Country:US
Practice Address - Phone:832-659-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3810207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB226622Medicare UPIN