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General NPI Number Information
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NPI Number | 1134673494
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Entity Type | Individual
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Provider Name | PAUL ANTHONY BRADLEY AG-CNS BC
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Gender | Male
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 3901A SPICEWOOD SPRINGS RD STE 201
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City | AUSTIN
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State | TX
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Zip | 78759-8728
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Country | US
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Telephone | 737-226-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 7316 LOOKOUT BLUFF TER
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City | AUSTIN
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State | TX
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Zip | 78735-8084
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | AP131482
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | AP131482
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License Number State | TX
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