MEDICARE: DR. BRUCE DAVID WOODS JR. D.C.

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	111N00000X	Chiropractor	11364	TX

General Provider Information

NPI Number	:	1558692525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE DAVID WOODS JR. D.C.

Provider Business Mailing Address
First Line	:	8330 LBJ FWY
Second Line	:	255
City	:	DALLAS
State	:	TX
Zip	:	75243-1166
Country	:	US
Telephone Number	:	972-804-6105
Fax Number	:

Provider Business Practice Location Address
First Line	:	8330 LBJ FWY
Second Line	:	255
City	:	DALLAS
State	:	TX
Zip	:	75243-1166
Country	:	US
Telephone Number	:	972-804-6105
Fax Number	:

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

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	03/21/2013

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