| Bruce Baca Pa | |
|
7120 I-40 W Suite 456 Amarillo TX 79106-2526 | |
| (806) 322-1074 | |
| Not Available |
| Full Name | Bruce Baca Pa |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7120 I-40 W, Amarillo, Texas |
| Authorized Official Name and Position | Bruce S Baca (PRESIDENT) |
| Authorized Official Contact | 8063221074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce Baca Pa Po Box 50862 Amarillo TX 79159-0862 Ph: (806) 322-1074 | Bruce Baca Pa 7120 I-40 W Suite 456 Amarillo TX 79106-2526 Ph: (806) 322-1074 |
| NPI Number | 1295981140 |
|---|---|
| Provider Enumeration Date | 08/12/2008 |
| Last Update Date | 10/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295981140 | NPI | - | NPPES |
| 108119202 | Medicaid | TX | |
| 00S01B | Other | BCBS TEXAS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 08001 (Texas) | Primary |
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