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General NPI Number Information
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NPI Number | 1124020318
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Entity Type | Individual
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Provider Name | BRIAN JAMES BRUENING M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 3525 19TH ST
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City | LUBBOCK
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State | TX
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Zip | 79410-1202
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Country | US
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Telephone | 806-687-8346
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Fax | 888-856-2848
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Provider Business Mailing Address
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Address Line | 4515 MARSHA SHARP FWY
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City | LUBBOCK
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State | TX
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Zip | 79407-2520
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Country | US
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Telephone | 806-744-7223
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Fax | 806-740-3325
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | H1268
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | H1268
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License Number State | TX
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