Individual
DR. BRADLEY BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L2152
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146838102
CSCHN1
TX
05
—
146838102
—
TX
01
—
146838103
CSHCN2
TX
05
—
146838103
—
TX
01
—
P00145598
RRMCARE
—
01
—
P00282122
RRMCARE2
—
Enumeration date
06/09/2005
Last updated
01/12/2015
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