Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | L7673 | TX |
NPI | 1174628028 |
---|---|
Provider Name | Eduardo D. Bruera |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 05/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46814201 | (05) | TX |
84677X | BCBS (01) | TX |
G98780 | (02) | |
P00242321 | RR MEDICARE (01) | TX |