Individual
ROBERT BRUCE CARRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 847556, DALLAS, TX 75284-7556
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
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