Individual
GORDON BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3320 LIVE OAK ST, COPC ADMINISTRATION, DALLAS, TX 75204-6109
(214) 266-1000
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
J4011
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
J4011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113281304
—
TX
05
—
113281305
—
TX
05
—
113281306
—
TX
05
—
113281307
—
TX
05
—
113281308
—
TX
05
—
113281309
—
TX
05
—
113281310
—
TX
05
—
113281311
—
TX
05
—
113281312
—
TX
05
—
113281313
—
TX
Enumeration date
12/15/2005
Last updated
12/15/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us