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THE BRADLEY CLINIC OF TEXAS PLLC NPI 1881069557


NPI Information

NPI: 1881069557
Provider Name: THE BRADLEY CLINIC OF TEXAS, PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1402 RICE RD
SUITE 100
TYLER, TX
ZIP 75703
Phone: (903) 630-7691
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THE BRADLEY CLINIC OF TEXAS, PLLC is a family medicine in Tyler, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. THE BRADLEY CLINIC OF TEXAS, PLLC NPI is 1881069557. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1402 RICE RD
SUITE 100
TYLER, TX
ZIP 75703-260
Phone: (903) 630-7691

The provider's authorized official is Dale J Bradley .
The authorized official title is President and has the following contact phone number (903) 630-7691.

The enumeration date for this NPI number is 12/7/2015 and was last updated on 3/25/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineL1276TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1365965801MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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