Individual
JASON THOMAS BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4321 MARSHA SHARP FWY, LUBBOCK, TX 79407-2504
(806) 686-3500
(806) 701-4973
Mailing address
4324 23RD ST, LUBBOCK, TX 79410-1812
(806) 686-3500
(806) 701-4184
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
L1532
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148315812
—
TX
05
—
14984032
—
NM
01
—
P01690378
RAILROAD MEDICARE PTAN
—
Enumeration date
12/22/2006
Last updated
06/19/2024
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