Provider Demographics
NPI:1295749257
Name:BRIDGES TO INC.
Entity type:Organization
Organization Name:BRIDGES TO INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONZEE
Authorized Official - Middle Name:MCINTYRE
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-219-8555
Mailing Address - Street 1:4300 YOUREE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3329
Mailing Address - Country:US
Mailing Address - Phone:318-219-8555
Mailing Address - Fax:318-219-8557
Practice Address - Street 1:4300 YOUREE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-3329
Practice Address - Country:US
Practice Address - Phone:318-219-8555
Practice Address - Fax:318-219-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017536208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA53056Medicare ID - Type Unspecified
LAB64339Medicare UPIN