Provider Demographics
NPI:1700377215
Name:LOYA, BRADON EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADON
Middle Name:EVAN
Last Name:LOYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2371 CROCKETT DR
Mailing Address - Street 2:STE 102
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5994
Mailing Address - Country:US
Mailing Address - Phone:806-743-2757
Mailing Address - Fax:
Practice Address - Street 1:2371 CROCKETT DR STE 102
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5994
Practice Address - Country:US
Practice Address - Phone:325-641-1140
Practice Address - Fax:325-641-5039
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
TXS3230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program