Individual provider · Type 1 NPI
Larry Edwin Bradley, DO
General Practice Physician · Fort Worth, TX
NPI number
1962711036
Active
Practice location
7016 Riverport Rd
Fort Worth, TX 76116-9311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | H6067 (TX) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
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About NPI 1962711036
Larry Edwin Bradley, DO's National Provider Identifier is 1962711036, issued on Oct 6, 2010. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Fort Worth, TX. The record was last updated on Oct 6, 2010.