Provider Demographics
NPI:1831465566
Name:KOEHLER, BRUCE ERIC II (MD)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:ERIC
Last Name:KOEHLER
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 S LANCASTER RD
Mailing Address - Street 2:#181
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-4555
Mailing Address - Country:US
Mailing Address - Phone:469-488-4600
Mailing Address - Fax:469-488-4601
Practice Address - Street 1:3200 S LANCASTER RD
Practice Address - Street 2:#181
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-4555
Practice Address - Country:US
Practice Address - Phone:469-488-4600
Practice Address - Fax:469-488-4601
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2015-09-15
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Provider Licenses
StateLicense IDTaxonomies
TXQ5681208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics