Bryan P Meyenberg, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT2053 Issued in TX

Practice address

1450 Metzger St BLDG 10416
Lackland AFB, TX 78236-5423

Phone

(210) 671-7744

NPI assigned

Sep 18, 2018

Last updated

Sep 18, 2018By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1457835290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25554 RIVER RNCH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782559548",
            "telephone_number": "210-884-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 METZGER ST BLDG 10416",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365423",
            "telephone_number": "210-671-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYENBERG",
        "first_name": "BRYAN",
        "middle_name": "P",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT2053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley McNealy, IDMT
• Christina McQuaide
• Rene Marie McQueen, PA-C
• Warren Miguel Meekins, CADAC
• Stephen Elliott Messier, MD
• Alisa Anne Miller, D.O.
• Noah Marcus Miller, D.M.D
• Susan Wright Mongeau, DDS, MPH
• Miguel A Montalvo, M.D.
• Rachel Anne Mooney, DDS

• Athletic Trainer in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.