Provider Demographics
NPI:1770034548
Name:CAUSSEAUX, BEAR BRUCE (FNP)
Entity Type:Individual
Prefix:
First Name:BEAR
Middle Name:BRUCE
Last Name:CAUSSEAUX
Suffix:
Gender:M
Credentials:FNP
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 64568
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-4568
Mailing Address - Country:US
Mailing Address - Phone:318-424-6004
Mailing Address - Fax:855-230-1466
Practice Address - Street 1:11750 US HIGHWAY 380
Practice Address - Street 2:STE 300
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-8200
Practice Address - Country:US
Practice Address - Phone:940-365-2273
Practice Address - Fax:940-365-2274
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0916373363LF0000X
TXAP132084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily