Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | N4928 | TX |
NPI | 1588780159 |
---|---|
Provider Name | Dr. Bradford Bader |
First Address | Plano, TX 75093-7712 |
Second Address | Plano, TX 75093-7712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 07/04/2020 |