Active NPI
Ricky Bradley
- Pharmacist
- Hillsboro, TX
National Provider Identifier
1841838414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24410
- Practice address
- 120 S Waco St
Hillsboro, TX 76645-7708 - Phone
- (254) 580-2953
- Fax
- (254) 580-2962
- NPI assigned
- Dec 14, 2019
- Last updated
- Dec 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24410 | TX | Primary |
Addresses
Primary practice location
120 S Waco St
Hillsboro, TX 76645-7708
Mailing address
120 S Waco St
Hillsboro, TX 76645-7708
Phone (254) 580-2953
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932272408 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24410 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brookshire Grocery Company | Past | Accepting new patients | |
| Brookshire Grocery Company | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Brookshires Pharmacy
- Community/Retail Pharmacy
- Hillsboro, TX
- NPI 1932272408
-
dba Reasor's Pharmacy #925
- Community/Retail Pharmacy
- Tulsa, OK
- NPI 1831138213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576281600000",
"number": "1841838414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 S WACO ST",
"city": "HILLSBORO",
"state": "TX",
"postal_code": "766457708",
"telephone_number": "254-580-2953",
"fax_number": "254-580-2962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S WACO ST",
"city": "HILLSBORO",
"state": "TX",
"postal_code": "766457708",
"telephone_number": "254-580-2953",
"fax_number": "254-580-2962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "RICKY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-14",
"last_updated": "2019-12-14",
"certification_date": "2019-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "24410",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932272408",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, TX
- Jason R Bauerschlag, MD
- Carol B Beyer, MD
- Bio-Medical Applications of Texas, Inc. (Fresenius Medical Care Hillsboro Kidney Center)
- Bio-Medical Applications of Texas, Inc. (Fresenius Medical Care Hillsboro Kidney Clinic)
- Jena R Bodeker, RDN,LD
- Sydney Anne Bredehoeft, ATC, LAT
- Brian Risinger
- Brookshire Grocery Company (Brookshires Pharmacy)
- Ashley L. Bubert, RD
- Britney Lee Burnett, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.