Individual
DAVID GLYNN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
917 E AUSTIN ST, NACOGDOCHES, TX 75965-2845
(936) 564-7373
Mailing address
917 E AUSTIN ST, NACOGDOCHES, TX 75965-2845
(936) 564-7373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679642250
M&S PHARMACY
TX
Enumeration date
05/02/2019
Last updated
11/27/2023
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