Provider Demographics
NPI:1164794517
Name:BRUCE, DANNY DUANE
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:DUANE
Last Name:BRUCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:D
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:935 W RALPH HALL PKWY STE 115
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-8701
Mailing Address - Country:US
Mailing Address - Phone:972-772-8484
Mailing Address - Fax:
Practice Address - Street 1:951 SMIRL DR
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-8943
Practice Address - Country:US
Practice Address - Phone:972-567-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health