Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1149 | TX |
NPI | 1073574943 |
---|---|
Provider Name | Dr. Bruce Allen Scudday |
First Address | El Paso, TX 79902-2905 |
Second Address | El Paso, TX 79902-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 25/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
089896701 | (05) | TX |
70286 | (05) | NM |
U05594 | (02) | TX |