Samuelson, Bradley E

Samuelson, Bradley E is an individual health care provider with primary practice located at 1004 Brook Ave , Wichita Falls TX 76301-5007. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Samuelson, Bradley E can be contacted via phone (940) 687-7100.

Contact Information

Primary practice address
1004 Brook Ave Wichita Falls TX 76301-5007
Phone: (940) 687-7100
Fax: (940) 687-7104
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X J5005 Texas

Profile Details

NPI number 1912015165
LBN Legal business name Samuelson, Bradley E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Oct 10th, 2012 - about 13 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 1912015165 NPPES
Texas MEDICAID 1022402-04

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