Provider Demographics
NPI:1477118768
Name:DELANEY, BRADLEY PEYTON (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:PEYTON
Last Name:DELANEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 SHOAL CREEK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7591
Mailing Address - Country:US
Mailing Address - Phone:512-617-7312
Mailing Address - Fax:512-617-7313
Practice Address - Street 1:8500 SHOAL CREEK BLVD
Practice Address - Street 2:BLDG 3 STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7591
Practice Address - Country:US
Practice Address - Phone:512-617-7312
Practice Address - Fax:512-617-7313
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03938300183500000X
NY064251183500000X
LAPST.022736183500000X
MD26144183500000X
MN123791183500000X
TX48671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist