Individual
BRADLEY KYLE HAMMETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5016 S US HIGHWAY 75, RADIOLOGY DEPT, DENISON, TX 75020-4584
(903) 892-1131
(903) 327-8023
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
26184
OK
2085R0202X
Diagnostic Radiology Physician
37263
IA
2085R0202X
Diagnostic Radiology Physician
Primary
M9341
TX
2085R0202X
Diagnostic Radiology Physician
R-6954
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194365601
—
TX
05
—
200133330
—
OK
01
—
55046
WELLMARK BCBS
IA
Enumeration date
05/30/2007
Last updated
10/08/2021
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