Individual
MR. BRAD STACY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4214 98TH ST, LUBBOCK, TX 79423-3957
(806) 712-7878
(806) 722-7878
Mailing address
5521 50TH ST APT 807, LUBBOCK, TX 79414-1647
(979) 450-4602
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1085595
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058642202
—
TX
Enumeration date
06/10/2005
Last updated
02/12/2020
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