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Individual

BRADLEY JAMES KENESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 GATEWAY HILLS LN STE C, GRANBURY, TX 76049-7847
(682) 936-2544
Mailing address
100 GATEWAY HILLS LN STE C, GRANBURY, TX 76049-7847
(682) 936-2544

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
N6899
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
N6899
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
219211401
TX
05
219211402
TX
01
8CQ572
BCBS
TX
01
8EH374
BCBS TX
TX
01
P00957426
RAILROAD
TX
Enumeration date
11/08/2010
Last updated
07/17/2025
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