Provider Demographics
NPI:1386840262
Name:THE BRIDGE
Entity Type:Organization
Organization Name:THE BRIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUNYA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLAIBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:713-697-2300
Mailing Address - Street 1:2925 W T C JESTER BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-7061
Mailing Address - Country:US
Mailing Address - Phone:713-697-2300
Mailing Address - Fax:
Practice Address - Street 1:2925 W T C JESTER BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7061
Practice Address - Country:US
Practice Address - Phone:713-697-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty