Individual
BRUCE ALAN SCHRADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3305 81ST ST, STE D, LUBBOCK, TX 79423-2042
(806) 745-8413
Mailing address
3305 81ST ST, STE D, LUBBOCK, TX 79423-2042
(806) 745-8413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16874
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019049801
—
TX
Enumeration date
03/21/2007
Last updated
02/28/2014
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