Organization
HEART HEALTH CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE MICHAEL GORDON DO (OWNER)
(469) 908-0040
Entity
Organization
Contact information
Practice address
808 WOODROW WILSON RAY CIR, BRIDGEPORT, TX 76426-2061
(469) 908-0400
(469) 908-0401
Mailing address
3409 RAMBLING WAY, PLANO, TX 75093-7601
(469) 908-0400
(469) 908-0401
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
K5967
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K5967
MEDICAL LICENSE NUMBER
TX
Enumeration date
10/13/2017
Last updated
03/17/2018
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