Provider Demographics
NPI:1033399720
Name:BRIDGES-ROSCHMANN, SIMONE M (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMONE
Middle Name:M
Last Name:BRIDGES-ROSCHMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SIMONE
Other - Middle Name:M
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 17916
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1034
Mailing Address - Country:US
Mailing Address - Phone:888-896-9369
Mailing Address - Fax:775-852-6902
Practice Address - Street 1:218 QUINLAN ST # 372
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5314
Practice Address - Country:US
Practice Address - Phone:830-997-1268
Practice Address - Fax:775-852-6902
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN27632085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CA893OtherBCBS
TX204232701Medicaid
TX204232702OtherCSHCN
TX204232701Medicaid