MEDICARE: DR. BRADFORD BADER MD

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	N4928	TX

General Provider Information

NPI Number	:	1588780159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADFORD BADER MD

Provider Business Mailing Address
First Line	:	3310 DALLAS PKWY STE 201
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7712
Country	:	US
Telephone Number	:	214-501-2021
Fax Number	:	214-501-2424

Provider Business Practice Location Address
First Line	:	3310 DALLAS PKWY STE 201
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7712
Country	:	US
Telephone Number	:	214-501-2021
Fax Number	:	214-501-2424

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	04/07/2020

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