Basic Information
Provider Information
NPI: 1578925913
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRADLEY
FirstName: LYNDSEY
MiddleName: MORGAN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 4692913369
FaxNumber: 2146450078
Practice Location
Address1: 5323 HARRY HINES BLVD STOP 7200
Address2:  
City: DALLAS
State: TX
PostalCode: 753907419
CountryCode: US
TelephoneNumber: 2146486400
FaxNumber: 2146485461
Other Information
ProviderEnumerationDate: 03/24/2016
LastUpdateDate: 10/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XT2122TXN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900XT2122TXY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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