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General NPI Number Information
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NPI Number | 1356910483
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Entity Type | Individual
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Provider Name | MARISSA ANN BRADFORD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 1735 S VOSS RD
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City | HOUSTON
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State | TX
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Zip | 77057-2603
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Country | US
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Telephone | 832-384-0042
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Fax |
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Provider Business Mailing Address
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Address Line | 8128 CANNON ST
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City | HOUSTON
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State | TX
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Zip | 77051-1111
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Country | US
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Telephone | 716-698-2416
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 81076
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 81076
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License Number State | TX
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