Gordon Bruce, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

J4011 Issued in TX

Practice address

3320 Live Oak St
Copc Administration
Dallas, TX 75204-6109

Phone

(214) 266-1000

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gbruce11002@direct.phhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• Dallas County Hospital District

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1649278995
  Medicare reassignment
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1750351375
  NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019

  Pediatric Emergency Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1295711901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 LIVE OAK ST",
            "address_2": "COPC ADMINISTRATION",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046109",
            "telephone_number": "214-266-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J4011",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "J4011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281311",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281312",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281313",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281304",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281310",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281308",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281309",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281306",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281305",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113281307",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce D Woods Jr
• Bruce E Whitehead, MD, PA
• Bruce E. Wardle', D.O, P.a.
• Brandon Bruce
• Estrelita Bruce, LPC
• Heather Anne Bruce, D.O.
• Rachel Bruce
• Robert L Bruce, M.D.
• Spencer Bruce
• Nathan Bruck, MD

• Pediatric Emergency Medicine (Pediatrics) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.