Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | MDK9743 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | MDK9743 | TX |
NPI | 1396781423 |
---|---|
Provider Name | Mr. Bruce A Byrne |
First Address | Richardson, TX 75082-3566 |
Second Address | Rockwall, TX 75087-2569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 13/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G62038 | (02) |