Provider Demographics
NPI:1801897640
Name:BEGIA, BRUCE CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:CHARLES
Last Name:BEGIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E BANDERA RD STE 102
Mailing Address - Street 2:WELLMED AT BOERNE
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006
Mailing Address - Country:US
Mailing Address - Phone:830-816-2312
Mailing Address - Fax:830-816-2349
Practice Address - Street 1:124 E BANDERA RD STE 102
Practice Address - Street 2:WELLMED AT BOERNE
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:830-816-2312
Practice Address - Fax:830-816-2349
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3984207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121278907Medicaid
TX080120052OtherRAILROAD MEDICARE
TX84220FOtherBLUE CROSS BLUE SHIELD
TX121278902Medicaid
TXJ3984OtherTX LICENSE NUMBER
TX080120052OtherRAILROAD MEDICARE
TX121278907Medicaid
8B8256Medicare PIN