Individual
DR. BRADLEY WILLIAM NORDYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
191 E PRICE RD, BROWNSVILLE, TX 78521-3527
(956) 621-3593
(956) 621-3689
Mailing address
191 E PRICE RD, BROWNSVILLE, TX 78521-3527
(956) 621-3593
(956) 621-3689
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
J7115
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1269698-03
—
TX
05
—
1269698-04
—
TX
01
—
126969811
MEDICAID - MAOB
TX
01
—
1F0206
MEDICARE - MAOB
TX
Enumeration date
04/27/2006
Last updated
12/06/2021
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