# PAUL BRADLEY MD PLLC

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

## Provider details

- **NPI number:** 1649780453
- **Authorized official:** PAUL BRADLEY MD (PRESIDENT)
- **Authorized official phone:** (903) 315-4455

## Contact information

- **Practice address:** 703 E MARSHALL AVE STE 4009, LONGVIEW, TX 75601-5500
- **Practice address phone:** (903) 315-4455
- **Mailing address:** PO BOX 3002, LONGVIEW, TX 75606-3002
- **Mailing address phone:** (903) 331-0506
- **Mailing address fax:** (903) 331-0462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | P6344 | TX | Yes |

## Other

- **Enumeration date:** 10/06/2017
- **Last updated:** 10/06/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | P6344 | TEXAS MEDICAL BOARD | TX |