Individual
DR. BRADLEY R. TROTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-0503
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
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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