Individual
BRAD RODNEY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1701 E PFLUGERVILLE PKWY, PFLUGERVILLE, TX 78660-8990
(512) 259-6000
(512) 260-6005
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
(801) 715-8228
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5166627-1206
UT
363AM0700X
Medical Physician Assistant
Primary
PA02752
TX
Other
Enumeration date
07/18/2006
Last updated
03/31/2025
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