MEDICARE: BRIDGET CORREA

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1518742055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET CORREA

Provider Business Mailing Address
First Line	:	6405 ABILENE TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-3421
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MEDICAL PKWY
Second Line	:
City	:	LAKEWAY
State	:	TX
Zip	:	78738-1791
Country	:	US
Telephone Number	:	737-237-0016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	09/01/2023

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Directions to “ BRIDGET CORREA ” Practice Location

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