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NPI Code Detail

MEDICARE: DANIEL EDWARD BRUHL M.D.

MEDICARE: DANIEL EDWARD BRUHL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianD4053TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
288Z902OTHERTXBCBS

General Provider Information

NPI Number : 1033115357
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL EDWARD BRUHL M.D.
Provider Business Mailing Address
First Line : 1201 SUMMIT AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-4427
Country : US
Telephone Number : 817-332-2020
Fax Number : 817-332-4797
Provider Business Practice Location Address
First Line : 1201 SUMMIT AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-4427
Country : US
Telephone Number : 817-332-2020
Fax Number : 817-332-4797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 05/05/2014

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