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General NPI Number Information
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NPI Number | 1861651424
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Entity Type | Individual
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Provider Name | JASON CLARK BRADFORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2008
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 545 CREEKSIDE XING STE 230
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-7532
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Country | US
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Telephone | 830-302-4404
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Fax | 830-302-4407
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Provider Business Mailing Address
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Address Line | PO BOX 5730
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City | BELFAST
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State | ME
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Zip | 04915-5700
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Country | US
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Telephone |
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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 | N2012
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License Number State | TX
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