Provider Demographics
NPI:1457387524
Name:LYMAN, BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:LYMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 JUNCTION HWY
Mailing Address - Street 2:STE B
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028
Mailing Address - Country:US
Mailing Address - Phone:830-895-9595
Mailing Address - Fax:830-895-9595
Practice Address - Street 1:1016 JUNCTION HWY
Practice Address - Street 2:STE B
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-895-9595
Practice Address - Fax:830-895-9595
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1457387524Medicare PIN
TX609720Medicare ID - Type Unspecified