Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SUSAN BRADDOCK
Active Sole ProprietorSUSAN BRADDOCK is a Clinic/Center healthcare provider located in FORT WORTH, Texas. NPI 1528635141 is currently active in the NPPES registry. Verify at CMS.
Clinic/Center · FORT WORTH, TX
Registration Details
- NPI Number
- 1528635141
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 10, 2021 (5.1425471105892 yrs)
- Last Updated
- Jun 10, 2021
- Sole Proprietor
- Yes
Practice Information
- Address
-
2009 TREMONT AVEFORT WORTH, TX, 761073959Browse TX providers · Browse ZIP 76107
- Phone
- 8173956284
- Fax
- 8174237734
- Primary Specialty
-
Clinic/Center
261Q00000X
Other Clinic/Center Providers in FORT WORTH, TX
| Name | Credential | NPI |
|---|---|---|
| MR. JOE LOUIS SIMMONS | R.PH | 1669726840 |
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.