Provider Demographics
NPI:1013965045
Name:HOFFMAN, BRYAN P (DO)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:P
Last Name:HOFFMAN
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 1:1306 TEASLEY LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7946
Mailing Address - Country:US
Mailing Address - Phone:940-382-5005
Mailing Address - Fax:940-565-5803
Practice Address - Street 1:1306 TEASLEY LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7946
Practice Address - Country:US
Practice Address - Phone:940-382-5005
Practice Address - Fax:940-565-5803
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0266207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141026805Medicaid
TX141026801Medicaid
TX141026803Medicaid
TX141026804Medicaid
TX8F1024Medicare ID - Type UnspecifiedDENTON FAMHEALTHCARE
TX141026801Medicaid
TX8718B9Medicare ID - Type UnspecifiedHIGHWAY 30 FAM MED
TX141026805Medicaid
TX8F3053Medicare PIN