Individual
BRADFORD A GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6300 W PARKER RD, STE 326, PLANO, TX 75093-8100
(972) 378-0633
(972) 378-0656
Mailing address
6300 W PARKER RD, STE 326, PLANO, TX 75093-8100
(972) 378-0633
(972) 378-0656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K3577
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040014024
MEDICARE RAILROAD PIN
—
01
—
7082003
AETNA PROVIDER NUMBER
TX
01
—
83560X
BCBS PROVIDER NUMBER
TX
Enumeration date
05/19/2006
Last updated
09/20/2013
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