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General NPI Number Information
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NPI Number | 1366679979
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Entity Type | Individual
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Provider Name | HELENA DAWN NICOLE BRUCE PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 1400 N IH 35 STE 300
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City | AUSTIN
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State | TX
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Zip | 78701-1926
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Country | US
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Telephone | 512-324-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 7601 RIALTO BLVD APT 1928
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City | AUSTIN
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State | TX
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Zip | 78735-7400
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Country | US
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Telephone |
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 25MP00216600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 013197
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA07620
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License Number State | TX
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