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Organization

PAUL BRADLEY MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL BRADLEY MD (PRESIDENT)
(903) 315-4455
Entity
Organization

Contact information

Practice address
703 E MARSHALL AVE STE 4009, LONGVIEW, TX 75601-5500
(903) 315-4455
Mailing address
PO BOX 3002, LONGVIEW, TX 75606-3002
(903) 331-0506
(903) 331-0462

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
P6344
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P6344
TEXAS MEDICAL BOARD
TX
Enumeration date
10/06/2017
Last updated
10/06/2017
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