Healthcare Provider Details

I. General information

NPI: 1053725275
Provider Name (Legal Business Name): BRUCE ADAM COLTON O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W FM 544 STE 109
MURPHY TX
75094-4228
US

IV. Provider business mailing address

601 W FM 544 STE 109
MURPHY TX
75094-4228
US

V. Phone/Fax

Practice location:
  • Phone: 972-578-2020
  • Fax: 972-476-1195
Mailing address:
  • Phone: 972-578-2020
  • Fax: 972-476-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number8439TG
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number8439TG
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number8439TG
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number8439TG
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number8439TG
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8439TG
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8439T
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number8439TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: