Individual
DR. BRADLY GREG MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
3550 N LAKELINE BLVD STE 180, LEANDER, TX 78641-3506
(281) 554-7080
Mailing address
192 GULF FWY S, STE C-2, LEAGUE CITY, TX 77573-3969
(281) 554-7080
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6940TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11748879
CAQH
—
Enumeration date
04/06/2007
Last updated
02/13/2023
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