Provider Demographics
NPI:1174992754
Name:BRADLEY HEALTH CARE GROUP, PLLC
Entity type:Organization
Organization Name:BRADLEY HEALTH CARE GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-526-5444
Mailing Address - Street 1:6110 DALROCK RD
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4402
Mailing Address - Country:US
Mailing Address - Phone:972-526-5444
Mailing Address - Fax:972-526-5445
Practice Address - Street 1:6110 DALROCK RD
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4402
Practice Address - Country:US
Practice Address - Phone:972-526-5444
Practice Address - Fax:972-526-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty