Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | F1364 | TX |
N | 111NI0900X | Internist | F1364 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | F1364 | TX |
Y | 207RI0011X | Interventional Cardiology | F1364 | TX |
NPI | 1083645576 |
---|---|
Provider Name | Bruce Edward Barnum |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77025-1669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129290601 | (05) | TX |
129290608 | (05) | TX |
129290611 | (05) | TX |