Provider Demographics
NPI:1295357127
Name:BRIDGES, JODY (PHARM D)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 E DAVIS ST APT 1124
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4523
Mailing Address - Country:US
Mailing Address - Phone:940-886-7753
Mailing Address - Fax:
Practice Address - Street 1:2300 W MORTON ST STE 121
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1600
Practice Address - Country:US
Practice Address - Phone:903-463-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist