Borucki, Michael John
Borucki, Michael John is an sole proprietor health care provider with primary practice located at 1600 Providence Dr Family Practice Center, Waco TX 76707-2261. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Borucki, Michael John can be contacted via phone (254) 750-8200.Contact Information
Primary practice address
1600 Providence Dr Family Practice Center
Waco TX 76707-2261
Phone: (254) 750-8200
Fax: (254) 750-8383
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | G6777 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G6777 | Texas |
Profile Details
| NPI number | 1194713230 |
|---|---|
| LBN Legal business name | Borucki, Michael John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Jan 14th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194713230 | NPPES |
| Texas | Other | 756.061.354 | TPI-TEXAS PROVIDER ID |
| Texas | MEDICAID | 122949405 | TPI-TEXAS PROVIDER ID |
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