Individual
BRADLY BUNDRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 HUTCHINS AVE STE C, BALLINGER, TX 76821-4453
(325) 365-5737
Mailing address
PO BOX 617, BALLINGER, TX 76821-0617
(325) 365-5737
(325) 365-2405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H7275
TX
207Q00000X
Family Medicine Physician
Primary
H7275
TX
207QS1201X
Sleep Medicine (Family Medicine) Physician
H7275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066DN
BCBS
TX
05
—
139813304
—
TX
05
—
139813338
—
TX
01
—
H7275
207P00000X
TX
Enumeration date
10/04/2005
Last updated
03/01/2019
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