Provider Demographics
NPI:1326023946
Name:BRUCE, TARA L (M D)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:L
Last Name:BRUCE
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
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Mailing Address - Street 1:7900 FANNIN ST STE 4000
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2935
Mailing Address - Country:US
Mailing Address - Phone:713-512-7500
Mailing Address - Fax:713-512-7622
Practice Address - Street 1:7900 FANNIN ST STE 4000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2935
Practice Address - Country:US
Practice Address - Phone:713-512-7500
Practice Address - Fax:713-512-7622
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9740207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX297039YTGMMedicare PIN