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NPI Code Detail

MEDICARE: DR. BRADLEY RAYMOND KOBY D.C.

MEDICARE: DR. BRADLEY RAYMOND KOBY D.C.
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
1111NS0005XSports Physician Chiropractor9546TX

General Provider Information

NPI Number : 1942202072
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADLEY RAYMOND KOBY D.C.
Provider Business Mailing Address
First Line : 4418 IRELAND LN
Second Line :
City : PASADENA
State : TX
Zip : 77505-4142
Country : US
Telephone Number : 281-998-0398
Fax Number : 281-487-6768
Provider Business Practice Location Address
First Line : 5912 SPENCER HWY
Second Line :
City : PASADENA
State : TX
Zip : 77505-1602
Country : US
Telephone Number : 281-998-5701
Fax Number : 281-487-6768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 07/08/2007

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Directions to “ DR. BRADLEY RAYMOND KOBY D.C.” Practice Location

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