Healthcare Provider Details

I. General information

NPI: 1417647348
Provider Name (Legal Business Name): BRADY MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 GAYLORD PKWY STE 1190
FRISCO TX
75034-9418
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:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: NIKEYIA BRAXTON
Title or Position: INSURANCE
Credential:
Phone: 206-851-1757