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Individual

JAMES MARK BRUYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
450 NORTH 11TH ST, BEAUMONT, TX 77702
(409) 833-7465
(409) 833-7719
Mailing address
450 NORTH 11TH ST, BEAUMONT, TX 77702
(409) 833-7465
(409) 833-7719

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0798
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120214506
TX
Enumeration date
09/15/2006
Last updated
07/03/2013
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