Bradley, Robert Wayne

Bradley, Robert Wayne is an individual health care provider with primary practice located at 2692 W Walnut St Suite 105, Garland TX 75042-6474. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bradley, Robert Wayne can be contacted via phone (972) 494-2676.

Contact Information

Primary practice address
2692 W Walnut St Suite 105 Garland TX 75042-6474
Phone: (972) 494-2676
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 22628 Texas

Profile Details

NPI number 1619969003
LBN Legal business name Bradley, Robert Wayne
Credentials PSYCHOLOGIST
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Jul 12th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619969003 NPPES
Texas MEDICAID 097798502

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