# SANDRA D.M. BRUNO, M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Moss Bluff Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295868024
- **Authorized official:** DR. SANDRA D BRUNO MD (OWNER)
- **Authorized official phone:** (337) 217-1000

## Contact information

- **Practice address:** 217 SAM HOUSTON JONES PKWY, SUITE 101, LAKE CHARLES, LA 70611-5603
- **Practice address phone:** (337) 217-1000
- **Mailing address:** 217 SAM HOUSTON JONES PKWY, SUITE 101, LAKE CHARLES, LA 70611-5603
- **Mailing address phone:** (337) 217-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 020956 | LA | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020