| Bradford White, Phd, Pllc | |
|
212 E Broadway St Ste 7 Prosper TX 75078-2935 | |
| (424) 242-2723 | |
| Not Available |
| Full Name | Bradford White, Phd, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 212 E Broadway St Ste 7, Prosper, Texas |
| Authorized Official Name and Position | Bradford White (OWNER) |
| Authorized Official Contact | 4242422723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradford White, Phd, Pllc 212 E Broadway St Ste 7 Prosper TX 75078-2935 Ph: (424) 242-2723 | Bradford White, Phd, Pllc 212 E Broadway St Ste 7 Prosper TX 75078-2935 Ph: (424) 242-2723 |
| NPI Number | 1336642032 |
|---|---|
| Provider Enumeration Date | 03/09/2018 |
| Last Update Date | 01/15/2021 |
| Certification Date | 01/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336642032 | NPI | - | NPPES |
| 1407204308 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 37415 (Texas) | Primary |
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