Provider Demographics
NPI:1891193900
Name:ORSMOND, BRUCE F (RPH)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:F
Last Name:ORSMOND
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-2879
Mailing Address - Fax:214-456-2698
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2879
Practice Address - Fax:214-456-2698
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53455183500000X
TX55314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX55314OtherTX STATE BOARD OF PHARMACY
CARPH 53455OtherCA BOARD OF PHARMACY