Organization
EDUCATION SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORMA Y BRADLEY (BILLING SPECIALIST)
(325) 658-6571
Entity
Organization
Contact information
Practice address
612 S IRENE, SAN ANGELO, TX 76903
(325) 658-6571
(325) 653-0036
Mailing address
612 S IRENE, SAN ANGELO, TX 76903
(325) 658-6571
(325) 653-0036
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
32054
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396867966
—
TX
Enumeration date
10/21/2010
Last updated
10/21/2010
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