Bruce W Allen, PH.D.
Individual provider Active NPI Clinical Psychologist · Waco, TX
NPI 1699881920 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699881920
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 25152 (TX)
- Practice address
- 4800 Memorial Dr
Waco, TX 76711-1329 - Phone
- (254) 297-3323
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25152 | TX | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 25152 | TX | Yes |
Addresses
Primary practice location
4800 Memorial Dr
Waco, TX 76711-1329
Mailing address
8924 Gladedale Dr
Woodway, TX 76712-3547
Phone (254) 776-3036
Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.