Provider Demographics
NPI:1851367981
Name:ALEXANDER, BRUCE JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JOHN
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 678355
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8355
Mailing Address - Country:US
Mailing Address - Phone:972-258-7499
Mailing Address - Fax:972-255-8922
Practice Address - Street 1:4500 HILLCREST RD
Practice Address - Street 2:SUITE 120
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:214-297-3000
Practice Address - Fax:214-297-3006
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK1336207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32724Medicare UPIN
TX8A2400Medicare ID - Type Unspecified