PAUL BRADLEY MD PLLC (NPI# 1649780453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649780453 |
| Entity Type | Organization |
| Organization Name | PAUL BRADLEY MD PLLC |
| Practice Address |
703 E Marshall Ave Ste 4009 Longview TX 75601-5500 |
| Mailing Address |
Po Box 3002 Longview TX 75606-3002 |
| Practice Telephone | 9033154455 |
| Mailing Telephone | 9033310506 |
| Mailing Fax Number | 9033310462 |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |
| Authorized Official Name | PAUL BRADLEY (PRESIDENT) |
| Authorized Official Telephone | 9033154455 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | P6344 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS MEDICAL BOARD | P6344 | 01 |
| Street Address |
703 E MARSHALL AVE STE 4009 |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75601-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992351076 | Stebbins Hospice LLC | Hospice Care, Community Based | 600-602 E. Whaley, Longview, TX 75601 | 2019-08-14 |
| 1720437692 | J.l. Miguez, Inc. | Hearing Aid Equipment | 822 N 4th Street, Longview, TX 75601 | 2016-06-10 |
| 1801244090 | Voyage Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 111 W Tyler St, Longview, TX 75601 | 2016-05-27 |
| 1134504426 | Siobain Kay Rogers | Nurse Practitioner | 703 E Marshall Ave Ste 4003, Longview, TX 75601 | 2015-07-28 |
| 1669882882 | Snehal Shrivastava | Internal Medicine | 1402 N 4th St Ste 300, Longview, TX 75601 | 2014-04-28 |
| 1679824221 | Jennifer Ruth Williams | Occupational Therapist | 110 E Tyler St, Longview, TX 75601 | 2012-09-23 |
| 1548525603 | Candice Renee Ramos | Social Worker | 950 N Sixth St, Longview, TX 75601 | 2012-07-05 |
| 1497082747 | Jarett S Harkness | Pharmacist | 511 E. Marshall Avenue, Longview, TX 75601 | 2009-11-06 |
| 1407086333 | Udeme Ekpenyong | Pediatrics | 818 N. 4th St., Longview, TX 75601 | 2009-07-27 |
| 1386823359 | Assisted Living Concepts Inc | Assisted Living Facility | 2104 Alpine Road, Longview, TX 75601 | 2007-10-26 |
| Find all providers in zip 75601 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457642282 | Landon Taylor Erickstad | Urology | 802 Medical Dr Ste 400, Longview, TX 75605-5205 | 2011-04-27 |
| 1639207574 | Gid Roger Johnson | Urology | 1608 Sweetbriar St, Longview, TX 75604-2654 | 2007-03-01 |
| 1780658112 | Robert W Frederick | Urology | 703 E Marshall Ave Ste 5007, Longview, TX 75601 | 2006-02-14 |
| 1285632919 | Patrick M Lassen | Urology | 625 9th Ave, Suite 120, Longview, WA 98632-2464 | 2005-07-07 |
| 1932369832 | Paul R Bradley | Urology | 703 E Marshall Ave, Suite 5007, Longview, TX 75601-5500 | 2008-06-13 |
| 1346430527 | Adrienne J K Carmack | Urology | 703 E Marshall Ave, Suite 5007, Longview, TX 75601-5500 | 2007-07-25 |
| 1790847994 | M'liss A Hudson | Urology | 802 Medical Dr, Suite 400, Longview, TX 75605-5100 | 2006-12-14 |
| 1588688402 | John Thomas Mansfield | Urology | 625 9th Ave, Suite 120, Longview, WA 98632-2464 | 2006-07-26 |
| 1700853793 | Gregory A Edwards | Urology | 802 Medical Dr, Suite 400, Longview, TX 75605-5100 | 2006-03-08 |
| 1588631576 | John M Ferrell | Urology | 703 E Marshall Ave, Suite 5008, Longview, TX 75601-5500 | 2006-03-08 |
| Find all providers in LONGVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.