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General NPI Number Information
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NPI Number | 1740236876
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Entity Type | Individual
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Provider Name | SUSAN MARIE BRADSHAW D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 3000 WESLAYAN ST STE 260
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City | HOUSTON
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State | TX
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Zip | 77027-5751
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Country | US
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Telephone | 713-337-2117
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Fax | 713-337-2118
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Provider Business Mailing Address
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Address Line | 3000 WESLAYAN ST STE 260
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City | HOUSTON
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State | TX
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Zip | 77027-5751
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Country | US
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Telephone | 713-337-2117
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Fax | 713-337-2118
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7605
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10711
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License Number State | TX
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