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NPI Code Detail

MEDICARE: JEFFREY L BRUCE OTR/L

MEDICARE: JEFFREY L BRUCE OTR/L
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
1225X00000XOccupational Therapist1129NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205893427
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY L BRUCE OTR/L
Provider Business Mailing Address
First Line : 1201 E 9TH ST
Second Line :
City : BONHAM
State : TX
Zip : 75418-4059
Country : US
Telephone Number : 903-583-6538
Fax Number :
Provider Business Practice Location Address
First Line : 1201 E 9TH ST
Second Line :
City : BONHAM
State : TX
Zip : 75418-4059
Country : US
Telephone Number : 903-583-6538
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 07/05/2016

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Directions to “ JEFFREY L BRUCE OTR/L” Practice Location

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