Provider Demographics
NPI:1730182304
Name:BRUNO, FELICE LUIGI (MD)
Entity type:Individual
Prefix:DR
First Name:FELICE
Middle Name:LUIGI
Last Name:BRUNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 MURCHISON DR
Mailing Address - Street 2:STE 211
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2931
Mailing Address - Country:US
Mailing Address - Phone:915-533-5100
Mailing Address - Fax:915-533-5101
Practice Address - Street 1:1700 MURCHISON DR
Practice Address - Street 2:STE 211
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2931
Practice Address - Country:US
Practice Address - Phone:915-533-5100
Practice Address - Fax:915-533-5101
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8362208G00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133929305Medicaid
TXD48033Medicare UPIN
TX133929305Medicaid