Provider Demographics
NPI:1083242093
Name:ANDERSEN, BRIDGET (RVS)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:RVS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4618 AVENUE R 1/2
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-5327
Mailing Address - Country:US
Mailing Address - Phone:409-599-4919
Mailing Address - Fax:
Practice Address - Street 1:4618 AVENUE R 1/2
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-5327
Practice Address - Country:US
Practice Address - Phone:409-599-4919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular-Interventional Technology