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General NPI Number Information
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NPI Number | 1538591714
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Entity Type | Organization
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Legal Business Name | BRIDGEWOOD SOUTH AUSTIN, LLC
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 211 E PARKWOOD AVE STE 100
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5152
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Country | US
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Telephone | 281-996-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 11300 FARRAH LANE
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City | AUSTIN
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State | TX
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Zip | 78748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARALEGAL
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Name | MS. PATRICIA E. COOK
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Credential |
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Telephone | 281-996-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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