Organization
BRADFORD WHITE, PHD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD WHITE PHD (OWNER)
(424) 242-2723
Entity
Organization
Contact information
Practice address
212 E BROADWAY ST STE 7, PROSPER, TX 75078-2935
(424) 242-2723
Mailing address
212 E BROADWAY ST STE 7, PROSPER, TX 75078-2935
(424) 242-2723
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
37415
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407204308
—
TX
Enumeration date
03/09/2018
Last updated
01/15/2021
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