Bradshaw, Wesley Alan
Bradshaw, Wesley Alan is an sole proprietor health care provider with primary practice located at 2626 Jbs Pkwy Suite 100A, Odessa TX 79761-1958. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Bradshaw, Wesley Alan can be contacted via phone (432) 333-2225.Contact Information
Primary practice address
2626 Jbs Pkwy Suite 100A
Odessa TX 79761-1958
Phone: (432) 333-2225
Fax: (432) 333-2226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 6046 | Texas |
Profile Details
| NPI number | 1679573406 |
|---|---|
| LBN Legal business name | Bradshaw, Wesley Alan |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | Sep 15th, 2008 - about 18 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 | 1679573406 | NPPES |
| Texas | MEDICAID | 083470701 |
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