Dr. Russell Bryan Bacak, M.D.
Family Medicine in College Station, TX. Individual provider (NPI-1).
NPI number1184705741
StatusActive
Last updated in NPPESJan 29, 2019
Details
- NPI
- 1184705741
- Entity type
- Individual (NPI-1)
- Name
- Dr. Russell Bryan Bacak
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2006
- Last updated
- Jan 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | K5445 | TX | Yes |
Practice location
2911 Texas Ave S Ste 202College Station, TX 77845-5388
Phone 979-695-3570 · Fax 979-695-3573
Mailing address
2911 Texas Ave S Ste 202College Station, TX 77845-5388
Phone 979-695-3570 · Fax 979-695-3573
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