Bogdan, Bradley Phillip

Bogdan, Bradley Phillip is an individual health care provider with primary practice located at 8441 State Highway 47 Ste 1400 , Bryan TX 77807-3208. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Bogdan, Bradley Phillip can be contacted via phone (979) 776-8440.

Contact Information

Primary practice address
8441 State Highway 47 Ste 1400 Bryan TX 77807-3208
Phone: (979) 776-8440
Fax: (877) 601-5854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1487907366
LBN Legal business name Bogdan, Bradley Phillip
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2012
Last updated Jul 15th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487907366 NPPES
Texas MEDICAID 361416602

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