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NPI Code Detail

MEDICARE: GARRY J. BRYDGES MSN, ACNP, CRNA

MEDICARE: GARRY J. BRYDGES MSN, ACNP, CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist610463TX
2363LA2100XAcute Care Nurse Practitioner610463TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2430080271OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
183149UOTHERTXBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124116272
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARRY J. BRYDGES MSN, ACNP, CRNA
Provider Business Mailing Address
First Line : PO BOX 4439
Second Line :
City : HOUSTON
State : TX
Zip : 77210-4439
Country : US
Telephone Number : 713-792-2991
Fax Number :
Provider Business Practice Location Address
First Line : 1504 TAUB LOOP
Second Line :
City : HOUSTON
State : TX
Zip : 77030-1608
Country : US
Telephone Number : 713-873-8890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 06/02/2026

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