| Bruce Conrad Puryear, MD | |
|
1541 Kings Hwy, Shreveport, LA 71103-4228 | |
| (318) 626-0000 | |
| Not Available |
| Full Name | Bruce Conrad Puryear |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 35 Years |
| Location | 1541 Kings Hwy, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821068016 | NPI | - | NPPES |
| P00286379 | Other | MEDICARE RAILROAD | |
| 620832 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | DR.0037671 (Colorado) | Secondary |
| 207L00000X | Anesthesiology | 29325 (Arizona) | Secondary |
| 207L00000X | Anesthesiology | 249692 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Uch-memorial Health System | Colorado springs, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Parkview Ancillary Services Corporation | 4385722511 | 273 |
| Poudre Valley Medical Group Llc | 9638208549 | 1992 |
| Entity Name | Parkview Ancillary Services Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982878765 PECOS PAC ID: 4385722511 Enrollment ID: O20080429000248 |
| Entity Name | Poudre Valley Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce Conrad Puryear, MD 1541 Kings Hwy, Attn: Payor Credentialing, Shreveport, LA 71103-4228 Ph: () - | Bruce Conrad Puryear, MD 1541 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 626-0000 |
Aya Mouhaffel, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Dr. James Williams, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1 Saint Mary Pl, Shreveport, LA 71101 Phone: 318-681-4440 | |
Maurice Hawley, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 2600 Greenwood Rd, Shreveport, LA 71103 Phone: 972-664-6963 Fax: 770-237-4731 | |
Hiram Vazquez, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 3217 Mabel St, Shreveport, LA 71103 Phone: 318-631-9121 Fax: 318-631-9126 | |
Azem Chami, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Cleveland S Waterman, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5581 | |
Dr. Akmal A Mikhail I, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-221-8411 |