Organization Active NPI

Nicole Bryan, MD PLLC

  • Otolaryngology Physician
  • Carrollton, TX
National Provider Identifier
1902216294
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
NICOLE BRYAN, MD PLLC
Practice address
1790 King Arthur Blvd
Suite 120
Carrollton, TX 75010
Phone
(972) 492-4006
Fax
(972) 492-7198
NPI assigned
May 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Nicole Bryan, M.D.
Title
Owner
Phone
(972) 492-4006

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

1790 King Arthur Blvd
Suite 120
Carrollton, TX 75010

Mailing address

1790 King Arthur Blvd
Suite 120
Carrollton, TX 75010
Phone (972) 492-4006

National Provider Directory

National Provider Directory

Locations

4325 N Josey Ln
Ste 101
Carrollton, TX 75010
Phone (972) 492-4006

1790 King Arthur Blvd
Ste 120
Carrollton, TX 75010
Phone (972) 492-4006

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1902216294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 KING ARTHUR BLVD",
            "address_2": "SUITE 120",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-492-4006",
            "fax_number": "972-492-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 KING ARTHUR BLVD",
            "address_2": "SUITE 120",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-492-4006",
            "fax_number": "972-492-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE BRYAN, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-492-4006",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.