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General NPI Number Information
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NPI Number | 1932136785
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Entity Type | Individual
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Provider Name | BRUCE LANCE ACKERMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 6446 BROADWAY BLVD
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City | GARLAND
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State | TX
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Zip | 75043-5943
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Country | US
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Telephone | 972-226-0575
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 PALM VALLEY DR
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City | GARLAND
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State | TX
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Zip | 75043-1340
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Country | US
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Telephone | 972-840-0733
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G1842
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License Number State | TX
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