Basic Information
| Provider Information | |||||||||
| NPI: | 1619358504 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRADLEY AND GRAY, INC | ||||||||
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| OtherOrganizationName: | EMPOWERING HANDS HOME HEALTHCARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4946 COMAL RIVER LOOP | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773863110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016134865 | ||||||||
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| Practice Location | |||||||||
| Address1: | 440 BENMAR DR | ||||||||
| Address2: | SUITE 2020 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770603165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322324147 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2015 | ||||||||
| LastUpdateDate: | 06/16/2015 | ||||||||
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| AuthorizedOfficialLastName: | BRADLEY | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | NURSING ADMINSTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6016134865 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN, BSN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 288202 | MS | N | Laboratories | Clinical Medical Laboratory | 314000000X | R894282 | MS | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.