Provider Demographics
NPI:1861827172
Name:BRADLEY AXLINE OBSTETRICS AND GYNECOLOGY, PA
Entity Type:Organization
Organization Name:BRADLEY AXLINE OBSTETRICS AND GYNECOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-538-2100
Mailing Address - Street 1:2560 CENTRAL PARK AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1563
Mailing Address - Country:US
Mailing Address - Phone:972-538-2100
Mailing Address - Fax:972-539-2231
Practice Address - Street 1:2560 CENTRAL PARK AVE
Practice Address - Street 2:340
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1554
Practice Address - Country:US
Practice Address - Phone:972-538-2100
Practice Address - Fax:972-539-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty