Healthcare Provider Details

I. General information

NPI: 1891884649
Provider Name (Legal Business Name): BRADLEY D VESSEL PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23051 KINGWOOD PLACE DR STE 110
KINGWOOD TX
77339-3962
US

IV. Provider business mailing address

PO BOX 1939 SUITE 130
LIVINGSTON TX
77351-0037
US

V. Phone/Fax

Practice location:
  • Phone: 281-819-1566
  • Fax:
Mailing address:
  • Phone: 713-960-8008
  • Fax: 713-960-0965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP119552
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number102750
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number693051
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number693051
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: