Individual
BRADLEY DOUGLAS POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2400 BROADMOOR DR STE C, BRYAN, TX 77802-2870
(979) 774-9255
(970) 774-9299
Mailing address
2400 BROADMOOR DR STE C, BRYAN, TX 77802-2870
(979) 774-9255
(970) 774-9299
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
32062
TX
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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