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Individual

BRUCE H BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 WATERS RIDGE, STE A, LEWISVILLE, TX 75057
(972) 219-0558
(972) 436-9273
Mailing address
3315 COLORADO BLVD, SUITE 102, DENTON, TX 76210-6884
(940) 320-1708
(940) 565-5457

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G7983
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122690406
TX
01
390007786
RR MEDICARE
Enumeration date
11/08/2005
Last updated
12/17/2015
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