Bruce Baca PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

08001 Issued in TX

Legal business name

BRUCE BACA PA

Practice address

7120 I-40 W
Suite 456
Amarillo, TX 79106-2526

Phone

(806) 322-1074

NPI assigned

Aug 12, 2008

Last updated

Oct 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bruce S Baca, LCSW

Title

President

Phone

(806) 322-1074

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1295981140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50862",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791590862",
            "telephone_number": "806-322-1074",
            "fax_number": "806-322-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 I-40 W",
            "address_2": "SUITE 456",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062526",
            "telephone_number": "806-322-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE BACA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "BACA",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-322-1074",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "08001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108119202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TEXAS",
            "identifier": "00S01B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tayla Brown
• William Richard Brown, CRNA
• Wade B Browne, CRNA
• Randall K Browning, DDS, MS
• Ricky Don Broyles, RDCS
• Benjamin Brue, PTA
• Jill Brue, LPC
• Henry David Bruton, MD
• James D Bryan, M.D.
• Kelsey Bryan, PTA

• Clinical Social Worker in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.