MEDICARE: DR. BRUCE RICHARD METCALF III 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	208VP0014X	Interventional Pain Medicine Physician	W3007	TX

General Provider Information

NPI Number	:	1477173938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE RICHARD METCALF III MD

Provider Business Mailing Address
First Line	:	9010 BRODIE LN STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5186
Country	:	US
Telephone Number	:	512-994-4159
Fax Number	:

Provider Business Practice Location Address
First Line	:	9010 BRODIE LN UNIT 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5184
Country	:	US
Telephone Number	:	512-994-4159
Fax Number	:

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

Provider Enumeration Date	:	04/24/2020
Last Update Date	:	05/28/2026

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