Healthcare Provider Details

I. General information

NPI: 1770034548
Provider Name (Legal Business Name): BEAR BRUCE CAUSSEAUX FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 PRESTON RD
FRISCO TX
75034-9438
US

IV. Provider business mailing address

PO BOX 64568
PHOENIX AZ
85082-4568
US

V. Phone/Fax

Practice location:
  • Phone: 469-495-9118
  • Fax:
Mailing address:
  • Phone: 318-424-6004
  • Fax: 855-230-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0916373
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132084
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: