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General NPI Number Information
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NPI Number | 1275846768
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Entity Type | Organization
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Legal Business Name | BRADFORD A. BADER, M.D., PLLC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 1600 COIT RD SUITE 406
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City | PLANO
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State | TX
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Zip | 75075-6174
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Country | US
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Telephone | 972-596-4005
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Fax | 972-985-1253
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Provider Business Mailing Address
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Address Line | 8380 WARREN PKWY SUITE 504
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City | FRISCO
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State | TX
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Zip | 75034-4198
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Country | US
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Telephone | 972-596-4005
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Fax | 972-985-1253
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRADFORD A BADER
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Credential | M.D.
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Telephone | 972-596-4005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | N4928
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License Number State | TX
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