Individual
DR. BRENT ALAN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2515 NASA PKWY, SUITE B 10, SEABROOK, TX 77586-3479
(832) 425-2495
Mailing address
2413 DUHON PL, SEABROOK, TX 77586-3351
(832) 425-2495
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
201382
TX
106H00000X
Marriage & Family Therapist
35001519A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388057
BCBS
IN
01
—
835937000
MAGELLAN
IN
Enumeration date
07/12/2006
Last updated
10/28/2011
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