Houston, Bradley L

Houston, Bradley L is an individual health care provider with primary practice located at 701 Hewitt Blvd , Red Wing MN 55066-2848. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Houston, Bradley L can be contacted via phone (651) 267-5000.

Contact Information

Primary practice address
701 Hewitt Blvd Red Wing MN 55066-2848
Phone: (651) 267-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD60758090 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 72960 Minnesota

Profile Details

NPI number 1275529240
LBN Legal business name Houston, Bradley L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Feb 8th, 2023 - about 3 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 1275529240 NPPES
Illinois MEDICAID 036101327

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