| Provider / Organization | NPI | Date Certified |
|---|---|---|
| RYAN BRADLEY | 1235862012 | 2022-08-14 |
Ryan Bradley is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1235862012. Registration indicates Ryan Bradley is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Ryan Bradley PA-C |
| Practice Office Address | 6028 SURETY DR EL PASO, TX US |
| Practice Office Telephone | 9155443500 |
| Mailing Address | 6028 SURETY DR EL PASO, TX 799052018 US |
| Business Telephone | 5753866585 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 1198847
TX |
| 514764972 | OTHER | NM | STATE DRIVERS L |