Individual
DR. BRUCE ALAN CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2624 POLO LN, PLANO, TX 75093-4772
(972) 682-0601
(972) 682-0661
Mailing address
2624 POLO LN, PLANO, TX 75093-4772
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E8389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1319600
—
TX
Enumeration date
08/03/2006
Last updated
07/16/2007
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