MEDICARE: BRADLEY C HOUSTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	E-15324	AR

General Provider Information

NPI Number	:	1154855401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY C HOUSTON M.D.

Provider Business Mailing Address
First Line	:	4301 W MARKHAM ST # 783
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	501-686-8000
Fax Number	:	501-526-5148

Provider Business Practice Location Address
First Line	:	10915 N RODNEY PARHAM RD STE F
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-4202
Country	:	US
Telephone Number	:	501-686-6324
Fax Number	:	501-526-8519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	04/29/2025

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Directions to “ BRADLEY C HOUSTON M.D.” Practice Location

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