MEDICARE: BRADY MEDICAL GROUP PLLC

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
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center
2	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1255186623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADY MEDICAL GROUP PLLC

Provider Business Mailing Address
First Line	:	3800 GAYLORD PKWY STE 1190
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-9418
Country	:	US
Telephone Number	:	844-409-4657
Fax Number	:	214-614-4277

Provider Business Practice Location Address
First Line	:	5477 GLEN LAKES DR STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4381
Country	:	US
Telephone Number	:	844-409-4657
Fax Number	:	214-614-4277

Authorized Official
Title or Position	:	INSURANCE COORDINATOR
Name	:	NIKEYIA BRAXTON
Credential	:
Telephone Number	:	844-409-4657

Provider Enumeration Date	:	04/19/2024
Last Update Date	:	04/19/2024

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