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Organization

BRUCE BACA PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRUCE S BACA LCSW (PRESIDENT)
(806) 322-1074
Entity
Organization

Contact information

Practice address
7120 I-40 W, SUITE 456, AMARILLO, TX 79106-2526
(806) 322-1074
Mailing address
PO BOX 50862, AMARILLO, TX 79159-0862
(806) 322-1074
(806) 322-1075

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
08001
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00S01B
BCBS TEXAS
05
108119202
TX
Enumeration date
08/12/2008
Last updated
10/13/2008
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