| Bruckerhoff Internal Medicine Associates | |
|
1788 Highway 157 N Ste 103 Mansfield TX 76063-3929 | |
| (817) 755-1005 | |
| (214) 506-2617 |
| Full Name | Bruckerhoff Internal Medicine Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 1788 Highway 157 N Ste 103, Mansfield, Texas |
| Authorized Official Name and Position | Denise Bruckerhoff (OWNER) |
| Authorized Official Contact | 8063355975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruckerhoff Internal Medicine Associates 9101 Lbj Fwy Ste 710 Dallas TX 75243-1912 Ph: (214) 506-2617 | Bruckerhoff Internal Medicine Associates 1788 Highway 157 N Ste 103 Mansfield TX 76063-3929 Ph: (817) 755-1005 |
| NPI Number | 1972062339 |
|---|---|
| Provider Enumeration Date | 03/15/2019 |
| Last Update Date | 08/13/2020 |
| Medicare PECOS PAC ID | 6901148741 |
|---|---|
| Medicare Enrollment ID | O20190429000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972062339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Denise K Bruckerhoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164690111 PECOS PAC ID: 8224189139 Enrollment ID: I20090706000117 |
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