Provider Demographics
NPI:1073803607
Name:ARTHUR, BRUCE
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:ARTHUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4975 PRESTON PARK BLVD
Mailing Address - Street 2:SUITE 790
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5164
Mailing Address - Country:US
Mailing Address - Phone:972-345-2910
Mailing Address - Fax:
Practice Address - Street 1:4975 PRESTON PARK BLVD
Practice Address - Street 2:SUITE 790
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5164
Practice Address - Country:US
Practice Address - Phone:972-345-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66563101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional