Healthcare Provider Details

I. General information

NPI: 1023629177
Provider Name (Legal Business Name): SHERRY LYNN BRADLEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 SPRING CYPRESS RD
CYPRESS TX
77429-6286
US

IV. Provider business mailing address

14100 SPRING CYPRESS RD
CYPRESS TX
77429-6286
US

V. Phone/Fax

Practice location:
  • Phone: 281-376-2428
  • Fax: 281-320-3783
Mailing address:
  • Phone: 281-376-2428
  • Fax: 281-320-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number40820
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: