| Bradley Friedman M.d. P.a. | |
|
11560 Teel Pkwy Suite #100 Frisco TX 75034-4430 | |
| (972) 668-0821 | |
| Not Available |
| Full Name | Bradley Friedman M.d. P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 11560 Teel Pkwy, Frisco, Texas |
| Authorized Official Name and Position | Bradley Ryan Friedman (OWNER) |
| Authorized Official Contact | 9726680821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Friedman M.d. P.a. 11560 Teel Pkwy Suite #100 Frisco TX 75034-4430 Ph: (972) 668-0821 | Bradley Friedman M.d. P.a. 11560 Teel Pkwy Suite #100 Frisco TX 75034-4430 Ph: (972) 668-0821 |
| NPI Number | 1487861589 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 01/29/2008 |
| Medicare PECOS PAC ID | 4688768567 |
|---|---|
| Medicare Enrollment ID | O20070922000196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487861589 | NPI | - | NPPES |
| 0095QC | Other | TX | BLUE CROSS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | M5168 (Texas) | Primary |
| Provider Name | Bradley R Friedman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033135066 PECOS PAC ID: 2860586732 Enrollment ID: I20070922000194 |
| Provider Name | Kristy D Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982624029 PECOS PAC ID: 4880784032 Enrollment ID: I20071212000406 |
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