| The Bradley Clinic Of Texas, Pllc | |
|
1402 Rice Rd Suite 100 Tyler TX 75703-3260 | |
| (903) 630-7691 | |
| Not Available |
| Full Name | The Bradley Clinic Of Texas, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1402 Rice Rd, Tyler, Texas |
| Authorized Official Name and Position | Dale J Bradley (PRESIDENT) |
| Authorized Official Contact | 9036307691 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bradley Clinic Of Texas, Pllc 1402 Rice Rd Suite 100 Tyler TX 75703-3260 Ph: (903) 630-7691 | The Bradley Clinic Of Texas, Pllc 1402 Rice Rd Suite 100 Tyler TX 75703-3260 Ph: (903) 630-7691 |
| NPI Number | 1881069557 |
|---|---|
| Provider Enumeration Date | 12/07/2015 |
| Last Update Date | 03/25/2020 |
| Medicare PECOS PAC ID | 3577869015 |
|---|---|
| Medicare Enrollment ID | O20160310000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881069557 | NPI | - | NPPES |
| 365965801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L1276 (Texas) | Primary |
| Provider Name | Dale J Bradley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588607428 PECOS PAC ID: 6608789250 Enrollment ID: I20031110000378 |
| Provider Name | Brandy Denise Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093174005 PECOS PAC ID: 8729386172 Enrollment ID: I20160418002295 |
| Provider Name | Amber N Lockman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265023881 PECOS PAC ID: 9335548882 Enrollment ID: I20210603000722 |
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Clifford D. Mullins, D.c., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14653 Eastside Rd, Tyler, TX 75707 Phone: 903-566-4449 | |
Frank P Reuter Jr Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 712 S Bois D Arc Ave, Tyler, TX 75701 Phone: 903-597-5579 Fax: 903-597-5722 | |
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