Individual
BRADLEY G BILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
103 N COLLEGE ST, CLARKSVILLE, TX 75426-2982
(903) 428-0090
(903) 428-0093
Mailing address
103 N COLLEGE ST, CLARKSVILLE, TX 75426-2982
(903) 428-0090
(903) 428-0093
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1090439
TX
225100000X
Physical Therapist
2634
OK
2251S0007X
Sports Physical Therapist
1090439
TX
2251X0800X
Orthopedic Physical Therapist
1090439
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058539001
—
TX
05
—
100835480A
—
OK
01
—
120487
SUPERIOR PROVIDER NUMBER
—
01
—
7680464
AETNA PROVIDER NUMBER
—
01
—
80814T
BCBS PROVIDER NUMBER
TX
Enumeration date
06/08/2006
Last updated
05/04/2020
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