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General NPI Number Information
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NPI Number | 1174623755
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Entity Type | Individual
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Provider Name | BRADLEY RAY ZIRKEL OTR
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 710 WATER ST
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City | KERRVILLE
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State | TX
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Zip | 78028-5329
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Country | US
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Telephone | 830-258-7442
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Fax |
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Provider Business Mailing Address
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Address Line | 14413 STATE HIGHWAY 16 N
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City | MEDINA
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State | TX
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Zip | 78055-3562
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Country | US
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Telephone | 830-589-7519
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 111143
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License Number State | TX
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