Individual
DR. LARRY EDWIN BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7016 RIVERPORT RD, FORT WORTH, TX 76116-9311
(817) 738-4288
Mailing address
7016 RIVERPORT RD, FORT WORTH, TX 76116-9311
(817) 738-4288
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
H6067
TX
Other
Enumeration date
10/06/2010
Last updated
10/06/2010
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