Organization
GLORIA RODARTE BRUN, M. D., P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLORIA RODARTE BRUN M. D. (PRESIDENT)
(903) 454-9404
Entity
Organization
Contact information
Practice address
5604 WESLEY ST, STE. 101, GREENVILLE, TX 75402-6326
(903) 454-9404
(903) 454-2129
Mailing address
5604 WESLEY ST, STE. 101, GREENVILLE, TX 75402-6326
(903) 454-9404
(903) 454-2129
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
J6890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0356321-01
—
TX
Enumeration date
03/07/2007
Last updated
06/24/2024
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