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NPI Code Detail

MEDICARE: REBECCA MICHELLE BRADLEY P.T.D.P.T

MEDICARE: REBECCA MICHELLE BRADLEY P.T.D.P.T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1144186TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11144186OTHERTXLICENSE

General Provider Information

NPI Number : 1023293297
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA MICHELLE BRADLEY P.T.D.P.T
Provider Business Mailing Address
First Line : 8000 FRANKFORD RD
Second Line :
City : DALLAS
State : TX
Zip : 75252-6834
Country : US
Telephone Number : 972-232-8096
Fax Number : 972-232-8099
Provider Business Practice Location Address
First Line : 8000 FRANKFORD RD
Second Line :
City : DALLAS
State : TX
Zip : 75252-6834
Country : US
Telephone Number : 972-232-8096
Fax Number : 972-232-8099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2008
Last Update Date : 11/15/2011

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