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General NPI Number Information
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NPI Number | 1235169400
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Entity Type | Individual
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Provider Name | PAUL DONNELLY BRIDGES PA
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 14493 S PADRE ISLAND DR A-320
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City | CORPUS CHRISTI
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State | TX
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Zip | 78418-5931
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Country | US
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Telephone | 361-815-8225
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Fax | 361-949-0525
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Provider Business Mailing Address
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Address Line | 14493 S PADRE ISLAND DR A-320
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City | CORPUS CHRISTI
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State | TX
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Zip | 78418-5931
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Country | US
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Telephone | 361-815-8225
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Fax | 361-949-0525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA01422
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License Number State | TX
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