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General NPI Number Information
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NPI Number | 1780686840
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Entity Type | Individual
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Provider Name | BRUCE G. KINZY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 30975 ELISE ANN
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City | BULVERDE
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State | TX
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Zip | 78163-4139
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Country | US
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Telephone | 830-980-4660
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Fax | 830-438-7646
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Provider Business Mailing Address
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Address Line | 30975 ELISE ANN
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City | BULVERDE
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State | TX
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Zip | 78163-4139
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Country | US
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Telephone | 830-980-4660
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Fax | 830-438-7646
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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 | D8745
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD33489
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30399
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D8745
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD33489
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 30399
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License Number State | KY
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