Bruce, Gordon

Bruce, Gordon is an individual health care provider with primary practice located at 3320 Live Oak St Copc Administration, Dallas TX 75204-6109. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Bruce, Gordon can be contacted via phone (214) 266-1000.

Contact Information

Primary practice address
3320 Live Oak St Copc Administration Dallas TX 75204-6109
Phone: (214) 266-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X J4011 Texas
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X J4011 Texas

Profile Details

NPI number 1295711901
LBN Legal business name Bruce, Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Dec 15th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295711901 NPPES
Texas MEDICAID 113281311
Texas MEDICAID 113281312
Texas MEDICAID 113281313
Texas MEDICAID 113281304
Texas MEDICAID 113281310
Texas MEDICAID 113281308
Texas MEDICAID 113281309
Texas MEDICAID 113281306
Texas MEDICAID 113281305
Texas MEDICAID 113281307

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