Healthcare Provider Details

I. General information

NPI: 1245086149
Provider Name (Legal Business Name): BRADY MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 MEDPARK DRIVE
DENTON TX
76208-6932
US

IV. Provider business mailing address

3800 GAYLORD PKWY STE 1190
FRISCO TX
75034-9418
US

V. Phone/Fax

Practice location:
  • Phone: 844-409-4657
  • Fax: 214-614-4277
Mailing address:
  • Phone: 844-409-4657
  • Fax: 214-614-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: NIKEYIA BRAXTON
Title or Position: INSURANCE COORDINATOR
Credential:
Phone: 844-409-4657