Healthcare Provider Details

I. General information

NPI: 1225198922
Provider Name (Legal Business Name): LEON C BRAMLETT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LEE BRAMLETT

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 SPRINGDALE RD
BEDFORD TX
76021-4313
US

IV. Provider business mailing address

821 SPRINGDALE RD
BEDFORD TX
76021-4313
US

V. Phone/Fax

Practice location:
  • Phone: 817-715-7710
  • Fax: 940-696-6275
Mailing address:
  • Phone: 817-715-7710
  • Fax: 940-696-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number16897
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: