Individual
BRUCE ALBERT BROCKWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3939 MEDICAL DR, 110, SAN ANTONIO, TX 78229
(210) 692-1515
(210) 692-0187
Mailing address
3939 MEDICAL DR, 110, SAN ANTONIO, TX 78229
(210) 692-1515
(210) 692-0187
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F1406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00GT38
BCBS OF TX
TX
Enumeration date
10/19/2006
Last updated
07/08/2007
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