# BRADLEY AXLINE MD OBSTETRICS AND GYNECOLOGY , PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073868139
- **Authorized official:** MR. NIZAR AHAMED (MGR)
- **Authorized official phone:** (301) 391-4184

## Contact information

- **Practice address:** 1408 DEER PATH, FLOWER MOUND, TX 75022
- **Practice address phone:** (301) 591-4184
- **Practice address fax:** (972) 559-3634
- **Mailing address:** 1408 DEER PATH, FLOWER MOUND, TX 75022
- **Mailing address phone:** (301) 591-4184
- **Mailing address fax:** (972) 559-3634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | J8198 | TX | Yes |

## Other

- **Enumeration date:** 07/16/2012
- **Last updated:** 07/16/2012