Provider Demographics
NPI:1841707676
Name:BRYANT, TAMMIE RENA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:RENA
Last Name:BRYANT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:TAMMIE
Other - Middle Name:RENA
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:14935 S RICHMOND AVE APT 1917
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1598
Mailing Address - Country:US
Mailing Address - Phone:713-498-3806
Mailing Address - Fax:
Practice Address - Street 1:14935 S RICHMOND AVE APT 1917
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1598
Practice Address - Country:US
Practice Address - Phone:713-498-3806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX661661363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care