Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 208547 | MA |
NPI | 1265423560 |
---|---|
Provider Name | Dr. Bruce A Meyer |
First Address | Dallas, TX 75390-9131 |
Second Address | Dallas, TX 75390-9131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 18/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0131300 | (05) | MA |
E66078 | (02) | MA |