Individual
BRUCE ALAN BOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 12TH AVE, SUITE 300, FORT WORTH, TX 76104-2519
(817) 877-1118
Mailing address
800 12TH AVE, SUITE 300, FORT WORTH, TX 76104-2518
(817) 877-1118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H1468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
POOOB02RO
—
TX
Enumeration date
06/07/2006
Last updated
04/22/2008
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