Bradford White, Phd, Pllc | |
212 E Broadway St Ste 7 Prosper TX 75078-2935 | |
(424) 242-2723 | |
Not Available |
Full Name | Bradford White, Phd, Pllc |
---|---|
Speciality | Psychologist - Clinical |
Location | 212 E Broadway St Ste 7, Prosper, Texas |
Authorized Official Name and Position | Bradford White (OWNER) |
Authorized Official Contact | 4242422723 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bradford White, Phd, Pllc 212 E Broadway St Ste 7 Prosper TX 75078-2935 Ph: (424) 242-2723 | Bradford White, Phd, Pllc 212 E Broadway St Ste 7 Prosper TX 75078-2935 Ph: (424) 242-2723 |
NPI Number | 1336642032 |
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Provider Enumeration Date | 03/09/2018 |
Last Update Date | 01/15/2021 |
Certification Date | 01/15/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336642032 | NPI | - | NPPES |
1407204308 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 37415 (Texas) | Primary |
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