Provider Demographics
NPI:1083209837
Name:HAVARD, BRIDGET M (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:HAVARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 LOUETTA RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2139
Mailing Address - Country:US
Mailing Address - Phone:281-257-7793
Mailing Address - Fax:281-257-7798
Practice Address - Street 1:12550 LOUETTA RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2139
Practice Address - Country:US
Practice Address - Phone:281-257-7793
Practice Address - Fax:281-257-7798
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist