Provider Demographics
NPI:1598840142
Name:ECKEL, BRUCE A (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:A
Last Name:ECKEL
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:2530 SCRIPTURE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4317
Practice Address - Country:US
Practice Address - Phone:940-898-1477
Practice Address - Fax:940-382-4091
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4570208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45165OtherFIRSTHEALTH PIN
TX89661YOtherBCBSTX IND PIN
TX3042298OtherCIGNA PIN
TX141908OtherPHCS PIN
TX131721607Medicaid
TX4097424OtherAETN APIN
TX875457OtherUHC PIN
1750369203OtherGRP NPI NUMBER
TX00U87ZOtherBCBSTX GRP PIN
TX131721608OtherCSHCN
1750369203OtherGRP NPI NUMBER