Provider Demographics
NPI:1497084859
Name:LEANA BRADFORD
Entity Type:Organization
Organization Name:LEANA BRADFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LEANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-733-6041
Mailing Address - Street 1:8730 SILVER LURE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-8151
Mailing Address - Country:US
Mailing Address - Phone:281-733-6041
Mailing Address - Fax:713-343-3158
Practice Address - Street 1:8730 SILVER LURE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-8151
Practice Address - Country:US
Practice Address - Phone:281-733-6041
Practice Address - Fax:713-343-3158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural