Individual
DOUGLAS O BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6601 W GORE BLVD., #6446, LAWTON, OK 73505-9998
(580) 355-7474
(580) 355-6765
Mailing address
PO BOX 6446, LAWTON, OK 73506-0446
(580) 355-7474
(580) 355-6765
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
198
OK
103T00000X
Psychologist
21363
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731279230001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
05/18/2007
Last updated
05/13/2022
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