Provider Demographics
NPI:1346274271
Name:FLASKA, BRAD L (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:L
Last Name:FLASKA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 E HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-5450
Mailing Address - Country:US
Mailing Address - Phone:940-325-9495
Mailing Address - Fax:940-325-9496
Practice Address - Street 1:913 E HUBBARD ST
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-5450
Practice Address - Country:US
Practice Address - Phone:940-325-9495
Practice Address - Fax:940-325-9496
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001413601Medicaid
TX001413601Medicaid
TX601953Medicare ID - Type Unspecified