Provider Demographics
NPI:1548248461
Name:BARKER, BRUCE ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALAN
Last Name:BARKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2660
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77404-2660
Mailing Address - Country:US
Mailing Address - Phone:979-323-9752
Mailing Address - Fax:979-323-9757
Practice Address - Street 1:2205 AVENUE K
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-5128
Practice Address - Country:US
Practice Address - Phone:979-323-9752
Practice Address - Fax:979-323-9757
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7305207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1548248461Medicaid
TX8CW948OtherBCBS-TX
1548248461OtherTRICARE SOUTH