Carolyn Denese Bradley-Guidry, MS, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02262 Issued in TX

Practice address

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Phone

(214) 645-8000

Fax

(214) 645-7269

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Carolyn Denese Bradley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1356379192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-6000",
            "fax_number": "214-645-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-645-8000",
            "fax_number": "214-645-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY-GUIDRY",
        "first_name": "CAROLYN",
        "middle_name": "DENESE",
        "name_prefix": "Mrs.",
        "credential": "MS, PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "BRADLEY",
            "middle_name": "DENESE",
            "prefix": "MRS.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer W. Bradford, PHD
• Katrina Marie Bradford, M.D.
• Rhonda Bradford, NP
• Shelby B Bradford, MCN, RD, LD
• Bradley Musser, MD PA
• Alice E. Bradley-Harmon, L.C.S.W.
• Aaron M Bradley, DPT
• Alicia Michelle Bradley
• Amanda B Bradley, ACNP, FNP
• Camille Marie Bradley, M.D.

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.