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General NPI Number Information
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NPI Number | 1831849637
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Entity Type | Individual
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Provider Name | BRUNO BITTENCOURT DOS SANTOS MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 2349 MEDICAL DR
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City | PECOS
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State | TX
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Zip | 79772-2251
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Country | US
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Telephone | 432-447-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 E SAUNDERS ST STE B680
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City | LAREDO
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State | TX
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Zip | 78041-5474
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Country | US
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Telephone | 956-796-4934
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | V5977
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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 | V5977
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License Number State | TX
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