Provider Demographics
NPI:1205082419
Name:TEEL, BRIANNA RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:RENEE
Last Name:TEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRIANNA
Other - Middle Name:RENEE
Other - Last Name:SWINKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 610393
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-0393
Mailing Address - Country:US
Mailing Address - Phone:903-757-6042
Mailing Address - Fax:903-232-8226
Practice Address - Street 1:707 HOLLYBROOK DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2410
Practice Address - Country:US
Practice Address - Phone:903-757-6042
Practice Address - Fax:903-232-8226
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK30205208100000X
TXS6070208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation