NPI 1104310192 · live from the CMS NPI Registry
Brent Steven Bruck, MD
Ophthalmology, Glaucoma Specialist in Omaha, NE. National Provider Identifier 1104310192, active.
NPI record
| NPI | 1104310192 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology, Glaucoma Specialist 207WX0009X |
| Practice location | 4353 Dodge St, Omaha, NE 68131 |
| Practice phone | 402-552-2020 |
| Enumerated | June 21, 2018 |
| Last updated | January 18, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology, Glaucoma Specialist primary | 207WX0009X | 35687 (NE) |
| Ophthalmology | 207W00000X | 35687 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.