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NPI Code Detail

MEDICARE: ALEXIS BRUCE

MEDICARE: ALEXIS BRUCE
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
1104100000XSocial Worker60063TX

General Provider Information

NPI Number : 1285392894
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS BRUCE
Provider Business Mailing Address
First Line : 11163 LA QUINTA PL STE B100
Second Line :
City : EL PASO
State : TX
Zip : 79936-5258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11163 LA QUINTA PL STE B100
Second Line :
City : EL PASO
State : TX
Zip : 79936-5258
Country : US
Telephone Number : 915-201-2606
Fax Number : 833-513-0981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2021
Last Update Date : 12/13/2021

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Directions to “ ALEXIS BRUCE ” Practice Location

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