Provider Demographics
NPI:1639250822
Name:BRADLEY, MELINDA HOPSON (OD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:HOPSON
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:SEAMAN
Other - Last Name:HOPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2430 FM 407
Mailing Address - Street 2:SUITE A
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077
Mailing Address - Country:US
Mailing Address - Phone:972-317-3937
Mailing Address - Fax:972-317-2320
Practice Address - Street 1:2430 FM 407
Practice Address - Street 2:SUITE A
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077
Practice Address - Country:US
Practice Address - Phone:972-317-3937
Practice Address - Fax:972-317-2320
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4144T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U 83201Medicare UPIN
TX8F23789Medicare PIN