| NPI | 1811137078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REATHA S BRADBERRY Nurse Practitioner 409-886-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 561891) |
| Enumeration Date | 2009-03-01 |
| Last Update Date | 2009-03-01 |