Michael Jack Bradley

Primary specialty

OpticianTaxonomy code 156FX1800X

License

R0166 Issued in TX

Practice address

6551 Harris Pkwy
Ste 205
Fort Worth, TX 76132-6103

Phone

(817) 370-6118

Fax

(817) 370-7118

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1407907348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY",
            "address_2": "STE 205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-370-6118",
            "fax_number": "817-370-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY",
            "address_2": "STE 205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326103",
            "telephone_number": "817-370-6118",
            "fax_number": "817-370-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MICHAEL",
        "middle_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "R0166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dora Linda Bradford, RNC,BSN,WHNP
• Laura Ann Bradford, M.D.
• Emily Bradley, LPC
• India Adell Bradley, LCSW
• Larry Edwin Bradley, D.O.
• Taylor Rentz Bradley, D.O.
• Charles Marshall Bradshaw, M.D., P.A.
• Amari Bradsher
• Jeremy Scott Brady, M.D.
• Sierra Brady

• Optician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.