Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLES MARSHALL BRADSHAW, M.D., P.A.
ActiveDR. CHARLES MARSHALL BRADSHAW, M.D., P.A. is a Sports Medicine (IM) healthcare provider located in FORT WORTH, Texas. NPI 1104866714 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (IM) · FORT WORTH, TX
Registration Details
- NPI Number
- 1104866714
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 8, 2006 (20.141770965348 yrs)
- Last Updated
- Mar 31, 2021
- Licenses
-
D2367 (TX)D2367 (TX)
Practice Information
- Address
-
2941 OAK PARK CIR STE 200FORT WORTH, TX, 761091852Browse TX providers · Browse ZIP 76109
- Phone
- 8173327433
- Fax
- 8173946282
- Primary Specialty
-
Sports Medicine (IM)
207RS0012X
- Additional Specialty
- Sports Medicine (IM)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.