Active NPI
Spencer Bruce
- Chiropractor
- Dallas, TX
National Provider Identifier
1407321060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 13920
- Practice address
- 5626 Fondren Dr
Dallas, TX 75206-4110 - Phone
- (469) 404-5460
- NPI assigned
- Oct 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 13920 | TX | Primary |
Addresses
Primary practice location
5626 Fondren Dr
Dallas, TX 75206-4110
Mailing address
5626 Fondren Dr
Dallas, TX 75206-4110
Phone (469) 404-5460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27-3221641 | Other | TX | OTHER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13920 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1407321060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5626 FONDREN DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752064110",
"telephone_number": "469-404-5460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5626 FONDREN DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752064110",
"telephone_number": "469-404-5460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "SPENCER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-10",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "13920",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER",
"identifier": "27-3221641",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.