Bryan Lee McCoy, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA02987 Issued in TX

Practice address

1711 Doolittle Ave
Fort Worth, TX 76127-1133

Phone

(817) 782-5913

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225014897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N KELSO AVE",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986264230",
            "telephone_number": "360-425-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 DOOLITTLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761271133",
            "telephone_number": "817-782-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "BRYAN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Annaliese McCormack, DO
• Alison Maureen McCormick, MD
• Audra Leigh McCormick
• Krista McCormick, SLP
• Rick Alvin McCormick, P.T.
• David Mac McCoy III, APRN-CNP, AGACNP-BC
• Jason McCoy, LMSW
• Jason M McCoy, LCSW
• Kristin McCoy, SLP
• Lakeshia McCoy, NP

• Medical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.