Provider Demographics
NPI:1659351252
Name:BRIDGES, DAVID L (O D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21642 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1646
Mailing Address - Country:US
Mailing Address - Phone:281-370-9931
Mailing Address - Fax:281-251-6899
Practice Address - Street 1:21642 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1646
Practice Address - Country:US
Practice Address - Phone:281-370-9931
Practice Address - Fax:281-251-6899
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2486TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT12368Medicare UPIN
TXOOE42DMedicare ID - Type Unspecified