Basic Information
| Provider Information | |||||||||
| NPI: | 1134462138 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRUCE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | DOUGLAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-P, PCCM | ||||||||
| Address2: | 3551 ROGER BROOKE DRIVE | ||||||||
| City: | JBSA-FORT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109162153 | ||||||||
| FaxNumber: | 2109160709 | ||||||||
| Practice Location | |||||||||
| Address1: | SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-P, PCCM | ||||||||
| Address2: | 3551 ROGER BROOKE DRIVE | ||||||||
| City: | JBSA-FORT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109162153 | ||||||||
| FaxNumber: | 2109160709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2013 | ||||||||
| LastUpdateDate: | 06/27/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 28260 | NE | N | Allopathic & Osteopathic Physicians | General Practice | 207R00000X | 28260 | NE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.