Provider Demographics
NPI:1033254123
Name:POLLOCK, BRUCE ANTHONY (LPC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ANTHONY
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20770 HWY 281
Mailing Address - Street 2:SUITE 108-196
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-481-0264
Mailing Address - Fax:210-481-3651
Practice Address - Street 1:20770 HWY 281 NORTH
Practice Address - Street 2:SUITE 108-196
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-481-0264
Practice Address - Fax:210-481-3651
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14283101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional