Individual
WILLIAM BRUCE HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 E HOUSTON ST, STE 600, TYLER, TX 75702-8369
(903) 526-2644
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
41278
TN
208800000X
Urology Physician
Primary
M9347
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139123002
—
TX
05
—
193123003
—
TX
05
—
19312301
—
TX
01
—
75-2616977-007
TRICARE-DOUGLAS
TX
01
—
75-2616977-008
TRICARE
TX
01
—
75-2616977-052
TRICARE
TX
01
—
75-2616977-095
TRICARE
TX
01
—
75-2616977-126
TRICARE
TX
01
—
752616977001
TRICARE
TX
01
—
752616977015
TRICARE
TX
01
—
752616977028
TRICARE
TX
01
—
752616977083
TRICARE
TX
01
—
752616977109
TRICARE
TX
01
—
8BC260
BCBS OF TEXAS
TX
Enumeration date
07/14/2006
Last updated
02/17/2016
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