Individual
DR. BRUCE WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 W MAIN STREET, GUN BARREL CITY, TX 75156-5312
(903) 887-1011
(903) 887-9441
Mailing address
PO BOX 1610, ATHENS, TX 75751-9004
(903) 887-1011
(903) 887-9441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M9450
ID
207Q00000X
Family Medicine Physician
Primary
P3269
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152435
REGENCE BS OF ID
ID
01
—
0204370
WA LABOR & INDUSTRIES
WA
05
—
302470501
—
TX
01
—
601417300
DEEIOC
—
01
—
76273
BLUE CROSS OF ID
ID
05
—
807296400
—
ID
05
—
8439838
—
WA
01
—
8DK990
BCBS OF TX
TX
Enumeration date
05/27/2005
Last updated
05/07/2024
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