Basic Information
| Provider Information | |||||||||
| NPI: | 1902153547 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCADAMS | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT, CSCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 RIVER HILLS DR | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786669501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127364393 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8335 AGORA PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SELMA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781541382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106588483 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2012 | ||||||||
| LastUpdateDate: | 08/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1221369 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.