Individual
DR. BRADLEY S MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 TROUP HWY, TYLER, TX 75701-8350
(903) 510-7006
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J8315
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130579906
—
TX
Enumeration date
02/15/2006
Last updated
10/13/2014
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