Individual
EBONY S BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3204 SHARPVIEW LN, DALLAS, TX 75228-6060
(469) 939-7851
Mailing address
3204 SHARPVIEW LN, DALLAS, TX 75228-6060
(469) 939-7851
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
23424503
TX
Other
Enumeration date
05/28/2013
Last updated
03/03/2023
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