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1104888585

NPI Code Detail

MEDICARE: BRUCE HOAK MD

MEDICARE: BRUCE HOAK 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	207Q00000X	Family Medicine Physician	G5175	TX
2	208600000X	Surgery Physician	G5175	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	80566Y	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1104888585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE HOAK MD

Provider Business Mailing Address
First Line	:	PO BOX 742712
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-2712
Country	:	US
Telephone Number	:	877-866-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	17218 PRESTON RD STE 2000
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-4018
Country	:	US
Telephone Number	:	877-866-7123
Fax Number	:

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	04/30/2024

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Directions to “ BRUCE HOAK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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