Individual
BRADFORD WAYNE MAXEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1023 ARLINGTON ST, ADA, OK 74820-4042
(580) 436-4400
(580) 436-4406
Mailing address
5228 WEST PLANO PKWY, PLANO, TX 75093
(972) 250-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
709
OK
363A00000X
Physician Assistant
PA00170
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87N208
BCBS
TX
01
—
970012800
RAILROAD
TX
Enumeration date
08/31/2006
Last updated
01/07/2019
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