Provider Demographics
NPI:1891884649
Name:VESSEL, BRADLEY D (PMHNP)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:D
Last Name:VESSEL
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1939
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-0037
Mailing Address - Country:US
Mailing Address - Phone:713-960-8008
Mailing Address - Fax:713-960-0965
Practice Address - Street 1:23051 KINGWOOD PLACE DR STE 110
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3962
Practice Address - Country:US
Practice Address - Phone:281-819-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119552363L00000X
LA102750363L00000X
TX693051363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner