Provider Demographics
NPI:1376239392
Name:EDWARDS, BRIDGETTE BUGGS
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:BUGGS
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12002 SOFT PINES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-2729
Mailing Address - Country:US
Mailing Address - Phone:281-662-8713
Mailing Address - Fax:
Practice Address - Street 1:12002 SOFT PINES DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-2729
Practice Address - Country:US
Practice Address - Phone:281-662-8713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty