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General NPI Number Information
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NPI Number | 1982644548
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Entity Type | Individual
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Provider Name | VANCY HOWARD BRIDGES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 1629 BROOK GROVE DR
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City | EULESS
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State | TX
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Zip | 76039-5269
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Country | US
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Telephone | 214-830-1057
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Fax | 214-988-2505
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Provider Business Mailing Address
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Address Line | 1629 BROOK GROVE DR
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City | EULESS
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State | TX
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Zip | 76039-5269
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Country | US
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Telephone | 214-830-1057
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Fax | 214-988-2505
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G7788
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License Number State | TX
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