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General NPI Number Information
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NPI Number | 1538167374
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Entity Type | Individual
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Provider Name | BRADLEY P AXLINE MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 2560 CENTRAL PARK AVE. #340
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City | FLOWER MOUND
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State | TX
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Zip | 75028
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Country | US
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Telephone | 972-538-2100
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Fax | 972-539-2231
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Provider Business Mailing Address
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Address Line | 2041 HAWTHORNE AVE
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City | FORT WORTH
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State | TX
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Zip | 76110-1739
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Country | US
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Telephone | 972-400-1726
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | J8198
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License Number State | TX
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