Provider Demographics
NPI:1053725275
Name:COLTON, BRUCE ADAM (OD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ADAM
Last Name:COLTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 W FM 544 STE 109
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4228
Mailing Address - Country:US
Mailing Address - Phone:972-578-2020
Mailing Address - Fax:972-476-1195
Practice Address - Street 1:601 W FM 544 STE 109
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4228
Practice Address - Country:US
Practice Address - Phone:972-578-2020
Practice Address - Fax:972-476-1195
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8439TG152WS0006X, 152WV0400X, 152WX0102X, 152WP0200X, 152WC0802X, 152W00000X, 152WL0500X
TX8439T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty