Bradford, Michael-David Robert
Bradford, Michael-David Robert is an sole proprietor health care provider with primary practice located at 3045 Trinity Lakes Dr , Hurst TX 76053-7458. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Bradford, Michael-David Robert can be contacted via phone (817) 726-8165.Contact Information
Primary practice address
3045 Trinity Lakes Dr
Hurst TX 76053-7458
Phone: (817) 726-8165
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 20103 | Texas |
Profile Details
| NPI number | 1114010451 |
|---|---|
| LBN Legal business name | Bradford, Michael-David Robert |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2006 |
| Last updated | Aug 31st, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114010451 | NPPES |
| Texas | MEDICAID | 178702001 |
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