Provider Demographics
NPI:1164459814
Name:HARMAN, BRUCE ALAN (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ALAN
Last Name:HARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 S. STEMMONS FREEWAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-5359
Mailing Address - Country:US
Mailing Address - Phone:972-434-8000
Mailing Address - Fax:972-434-8001
Practice Address - Street 1:1165 S. STEMMONS FREEWAY
Practice Address - Street 2:SUITE 108
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-5359
Practice Address - Country:US
Practice Address - Phone:972-434-8000
Practice Address - Fax:972-434-8001
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136858112Medicaid
TX136858110Medicaid
TX8A6060Medicare ID - Type Unspecified
TX136858112Medicaid
TX136858110Medicaid