BRADLEY ROBERTSON (NPI# 1760425326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760425326 |
| Entity Type | Individual |
| Full Name | BRADLEY ROBERTSON |
| Credential | MD |
| Practice Address |
1809 Capital Dr Tyler TX 75701-8438 |
| Practice Telephone | 9035094499 |
| Practice Fax Number | 9035094490 |
| Mailing Telephone | 9035094499 |
| Mailing Fax Number | 9035094490 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2008-04-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | H7648 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 0080EJ | 01 |
| TX | 139171613 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568580074 | Bradley Robertson | Dentist | 1212 N Cole Rd, Boise, ID 83704-8646 | 2007-03-26 |
| 1336151109 | Bradley Charles Robertson | Surgery | 1 Barrington Pl, Bel Air, MD 21014-5607 | 2006-08-12 |
| Street Address |
1809 CAPITAL DR |
| City | TYLER |
| State | TX |
| Zip Code | 75701-8438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013375740 | Cec Tyler Er Physicians Pllc | Emergency Medicine | 1809 Capital Dr, Tyler, TX 75701-8438 | 2016-02-09 |
| 1124486857 | Complete Emergency Care Tyler LLC | Clinic/Center | 1809 Capital Dr, Tyler, TX 75701-8438 | 2016-02-09 |
| 1528483591 | Stacy Laine Gregory | Nurse Practitioner | 1809 Capital Dr, Tyler, TX 75701-8438 | 2014-02-26 |
| 1053442368 | Tyler Urgent Care LLP | Emergency Medicine | 1809 Capital Dr, Tyler, TX 75701-8438 | 2007-03-08 |
| 1962445825 | William R Wallace | Emergency Medicine | 1809 Capital Dr, Tyler, TX 75701-8438 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407140106 | Mark W Mcdonald | Emergency Medicine | 629 Winding Brook Ln, Tyler, TX 75703-0832 | 2011-05-31 |
| 1235260084 | Michael Byron Taylor | Emergency Medicine | 3102 Lakepine Cir, Tyler, TX 75707-1724 | 2007-03-07 |
| 1346279031 | Jill Marie Wortham | Emergency Medicine | 6210 S. Broadway, Tyler, TX 75703 | 2006-07-03 |
| 1699719872 | East Texas Medical Center Healthcare Associates | Emergency Medicine | 1000 S Beckham, Tyler, TX 75701 | 2006-06-16 |
| 1326082892 | East Texas Medical Center Healthcare Associates | Emergency Medicine | 6210 S Broadway Ave, Tyler, TX 75703-4413 | 2006-06-15 |
| 1902849417 | Mack D Stewart | Emergency Medicine | 107 Robert E Lee Dr, Tyler, TX 75703-4602 | 2006-06-13 |
| 1295782977 | Sergio V Figueroa Jr. | Emergency Medicine | 1436 Hollytree Pl, Tyler, TX 75703-5774 | 2006-05-28 |
| 1144209354 | Paula Alinda Bessonett | Emergency Medicine | 222 E. Fifth Street, Tyler, TX 75701 | 2006-01-16 |
| 1871578989 | Evans Swann Smith | Emergency Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | 2005-12-12 |
| 1831189836 | Joseph Pistone | Emergency Medicine | 5414 S Broadway Ave, Tyler, TX 75703-1335 | 2005-10-21 |
| Find all providers in TYLER | ||||
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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.