Individual
BRADLEY LANE NEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2431 S LOOP 289, LUBBOCK, TX 79423-1519
(806) 771-8008
(806) 771-8009
Mailing address
2431 S LOOP 289, LUBBOCK, TX 79423-1519
(806) 771-8008
(806) 771-8009
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1191382
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193447100
FIRSTCARE
TX
05
—
219599201
—
TX
05
—
219599202
—
TX
01
—
825T83
BCBS
TX
01
—
P00804345
MEDICARE RAILROAD
TX
Enumeration date
09/14/2009
Last updated
11/15/2012
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