Provider Demographics
NPI:1821054776
Name:BRIDGES, DEBORAH (DEBBIE) ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH (DEBBIE)
Middle Name:ANN
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 HIDEAWAY LANE WEST
Mailing Address - Street 2:
Mailing Address - City:HIDEAWAY
Mailing Address - State:TX
Mailing Address - Zip Code:75771
Mailing Address - Country:US
Mailing Address - Phone:214-235-3086
Mailing Address - Fax:972-494-6572
Practice Address - Street 1:9 MEDICAL PARKWAY
Practice Address - Street 2:SUITE 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:469-914-4467
Practice Address - Fax:972-241-0459
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35500207RI0200X
TXL6806207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AD532OtherBCBS
TX182253801Medicaid