Individual
DR. BRADLEY R. TROTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J4571
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1246027-03
CSHCN
TX
05
—
1246027-04
—
TX
01
—
300115747
RR/MEDICARE
TX
01
—
86196J
BLUE SHIELD
TX
Enumeration date
04/05/2006
Last updated
12/30/2020
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