Provider Demographics
NPI:1669659835
Name:BELLARD, BRADFORD J (MD)
Entity Type:Individual
Prefix:MR
First Name:BRADFORD
Middle Name:J
Last Name:BELLARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6901 SNIDER PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5648
Mailing Address - Country:US
Mailing Address - Phone:214-369-7733
Mailing Address - Fax:214-369-7739
Practice Address - Street 1:6901 SNIDER PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5648
Practice Address - Country:US
Practice Address - Phone:214-369-7733
Practice Address - Fax:214-369-7739
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP0549207PS0010X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287747401Medicaid
TX287747401Medicaid