| Doctor Name: | MR. BRYAN LEE JANSSEN |
| NPI Number: | 1063667509 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | BP10032146 |
| Business Practice Address: | 2710 Hospital Dr Ste 112 Victoria, TX - 779015743 |
| Business Phone Number: | 3615821137 |
| Business Fax Number: | 3615735042 |
| Mailing Address: | 2710 Hospital Dr Ste 112, VICTORIA |
| State: | TX |
| Postal Code: | 779015743 |
| Phone Number: | 3615821137 |
| Fax Number: | 3615735042 |
| NPI Enumeration Date: | 11/25/2008 |
| NPI Last Update Date: | 08/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | BP10032146 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |