Provider Demographics
NPI:1013301894
Name:DANSHAW, BRIAN MATTHEW (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MATTHEW
Last Name:DANSHAW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 HARRIS PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4261
Mailing Address - Country:US
Mailing Address - Phone:817-916-4685
Mailing Address - Fax:817-769-3718
Practice Address - Street 1:6900 HARRIS PKWY STE 310
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4261
Practice Address - Country:US
Practice Address - Phone:817-916-4685
Practice Address - Fax:817-769-3718
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0761207XS0117X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty