Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | N8931 | TX |
NPI | 1124119854 |
---|---|
Provider Name | Bradley A Hubbard |
First Address | Dallas, TX 75265-0002 |
Second Address | Dallas, TX 75231-5956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 07/02/2020 |