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MR. BRADLEY LOUIS JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-5000
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
664987
TX
367500000X
Certified Registered Nurse Anesthetist
AP04179
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
289953603
TX
01
75-0818167-015
TRICARE
TX
01
8351UE
BCBS BLUE
TX
01
P01198527
RAIL ROAD
TX
Enumeration date
09/02/2006
Last updated
10/13/2014
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