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NPI Code Detail

MEDICARE: DR. BRADLEY W. CARPENTIER M.D.

MEDICARE: DR. BRADLEY W. CARPENTIER M.D.
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
1207LP2900XPain Medicine (Anesthesiology) PhysicianJ1913TX
2208VP0014XInterventional Pain Medicine PhysicianJ1913TX

General Provider Information

NPI Number : 1568577211
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADLEY W. CARPENTIER M.D.
Provider Business Mailing Address
First Line : PO BOX 2025
Second Line :
City : BELTON
State : TX
Zip : 76513-6125
Country : US
Telephone Number : 254-300-8339
Fax Number : 844-214-2393
Provider Business Practice Location Address
First Line : 716 INDIAN TRL
Second Line : STE 120
City : HARKER HEIGHTS
State : TX
Zip : 76548-5702
Country : US
Telephone Number : 254-300-8339
Fax Number : 844-214-2393
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 04/20/2018

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