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General NPI Number Information
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NPI Number | 1053455311
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Entity Type | Individual
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Provider Name | BRUCE A HENRY M.D.,P.A.
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Gender | Male
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 2001 SE GREEN OAKS BLVD STE 100
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City | ARLINGTON
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State | TX
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Zip | 76018-0953
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Country | US
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Telephone | 817-466-7412
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Fax | 817-466-7493
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Provider Business Mailing Address
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Address Line | 2001 SE GREEN OAKS BLVD STE 100
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City | ARLINGTON
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State | TX
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Zip | 76018-0953
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Country | US
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Telephone | 817-466-7412
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Fax | 817-466-7493
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H2454
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License Number State | TX
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