Individual
BRUCE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4100 INTERNATIONAL PLZ, SUITE 600, FORT WORTH, TX 76109-4820
(817) 529-1157
(817) 877-0350
Mailing address
4100 INTERNATIONAL PLZ, SUITE 600, FORT WORTH, TX 76109-4820
(817) 529-1157
(817) 877-0350
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
706059
TX
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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