Provider Demographics
NPI:1669911624
Name:MUENCH, BRYAN (PT, MPT, PCS)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:MUENCH
Suffix:
Gender:M
Credentials:PT, MPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22452 COUNTY ROAD 3107
Mailing Address - Street 2:
Mailing Address - City:GLADEWATER
Mailing Address - State:TX
Mailing Address - Zip Code:75647-9690
Mailing Address - Country:US
Mailing Address - Phone:903-985-1098
Mailing Address - Fax:
Practice Address - Street 1:22452 COUNTY ROAD 3107
Practice Address - Street 2:
Practice Address - City:GLADEWATER
Practice Address - State:TX
Practice Address - Zip Code:75647-9690
Practice Address - Country:US
Practice Address - Phone:903-985-1098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11439642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics