Provider Demographics
NPI:1306234877
Name:ABELL, BRAD ALAN (MED, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:BRAD
Middle Name:ALAN
Last Name:ABELL
Suffix:
Gender:M
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SOLOMON DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-3633
Mailing Address - Country:US
Mailing Address - Phone:903-366-9483
Mailing Address - Fax:
Practice Address - Street 1:1015 SOLOMON DR
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-3633
Practice Address - Country:US
Practice Address - Phone:903-366-9483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT16812255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer