Individual provider Active NPI

Bryan W. Hambric, M.D.

  • Surgery Physician
  • San Angelo, TX
National Provider Identifier
1811047954
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
K4698 Issued in TX
Practice address
102 N Magdalen St
San Angelo, TX 76903-5400
Phone
(325) 481-2344
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD.203206 LA
Surgery Physician 208600000X K4698 TX Primary

Addresses

Primary practice location

102 N Magdalen St
San Angelo, TX 76903-5400

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000545 TX Practitioner - General Surgery 0042366999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Baylor College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

102 N Magdalen
San Angelo, TX 76903
Phone (325) 747-1511

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.203206LAMDSurgery Physician
K4698TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Aug 1, 2021 Accepting new patients
Shannon Clinic Surgery CurrentSince Apr 1, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 1, 2021 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

102 N Magdalen St
San Angelo, TX 76903
Phone (325) 655-2200

1340 Wonder World Dr
Ste 4301
San Marcos, TX 78666
Phone (512) 353-6400

1305 Wonder World Dr
Ste 209
San Marcos, TX 78666
Phone (512) 353-6400

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: bhambric253626@christushealth.direct-ci.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1811047954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MAGDALEN ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035400",
            "telephone_number": "325-481-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBRIC",
        "first_name": "BRYAN",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "MD.203206",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K4698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.