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General NPI Number Information
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NPI Number | 1316936743
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Entity Type | Individual
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Provider Name | VICTOR ENRIQUE BRADLEY-ROLON MD MD INTERNIST
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 110 E SAVANNAH AVE BLDG A STE 201
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City | MCALLEN
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State | TX
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Zip | 78503
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Country | US
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Telephone | 956-780-5501
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Fax | 956-780-5501
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Provider Business Mailing Address
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Address Line | 110 E SAVANNAH AVE BLDG A STE 201
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City | MCALLEN
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State | TX
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Zip | 78503-1230
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Country | US
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Telephone | 956-631-2175
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Fax | 956-631-2175
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D4721
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License Number State | TX
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