Individual
ROBERT BRUCE CARRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03460
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196367001
—
TX
05
—
196367002
—
TX
01
—
P00645995
RAILROAD MEDICARE
TX
Enumeration date
06/13/2006
Last updated
07/18/2011
Update your record
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