Individual
BRADY MITCHELL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2455 NE LOOP 410, SUITE 100, SAN ANTONIO, TX 78217-5649
(210) 599-6000
(210) 657-5586
Mailing address
2455 NE LOOP 410, SUITE 100, SAN ANTONIO, TX 78217-5649
(210) 599-6000
(210) 657-5586
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313789501
WELLMED MEDICAID
TX
01
—
TXB155678
WELLMED MEDICAL GROUP PA
—
Enumeration date
07/07/2005
Last updated
10/17/2016
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