MEDICARE: M BRUCE CHRISTOPHERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	D8175	TX

General Provider Information

NPI Number	:	1023029675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	M BRUCE CHRISTOPHERSON MD

Provider Business Mailing Address
First Line	:	929 GESSNER RD
Second Line	:	STE. 2130
City	:	HOUSTON
State	:	TX
Zip	:	77024-2515
Country	:	US
Telephone Number	:	713-935-9100
Fax Number	:	713-935-9103

Provider Business Practice Location Address
First Line	:	929 GESSNER RD
Second Line	:	STE. 2130
City	:	HOUSTON
State	:	TX
Zip	:	77024-2515
Country	:	US
Telephone Number	:	713-935-9100
Fax Number	:	713-935-9103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	05/12/2016

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