Provider Demographics
NPI:1295742443
Name:ABEL, BRUCE JULES (PHD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JULES
Last Name:ABEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17134 EARTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1356
Mailing Address - Country:US
Mailing Address - Phone:972-578-0665
Mailing Address - Fax:972-578-8397
Practice Address - Street 1:1721 W PLANO PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8634
Practice Address - Country:US
Practice Address - Phone:972-578-0665
Practice Address - Fax:972-578-8397
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-2621103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFJ43Medicare ID - Type Unspecified