Provider Demographics
NPI:1407502867
Name:DAVIDSON, BRIDGETTE L (MD)
Entity type:Individual
Prefix:DR
First Name:BRIDGETTE
Middle Name:L
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US DEPARTMENT OF VETERAN AFFAIRS- OFFICE OF PSYCHIATRIS
Mailing Address - Street 2:1901 VETERAN MEMORIAL BLVD BLG147
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504
Mailing Address - Country:US
Mailing Address - Phone:254-743-2867
Mailing Address - Fax:
Practice Address - Street 1:US DEPARTMENT OF VETERAN AFFAIRS- OFFICE OF PSYCHIATRIS
Practice Address - Street 2:1901 VETERAN MEMORIAL BLVD BLG147
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504
Practice Address - Country:US
Practice Address - Phone:254-743-2867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL44464932084A0401X, 2084A2900X, 2084B0040X, 2084D0003X, 2084E0001X, 2084H0002X, 2084N0008X, 2084N0600X, 2084P0015X, 2084P0301X, 2084P0805X, 2084P2900X, 2084S0012X, 2084B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyObesity Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative Medicine
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury Medicine
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34721777OtherTRICARE CHAMPUS VA COPAY
TXL4446493Medicaid
TX34721777Medicaid
TXL4446493OtherALL
TX65674Medicaid
TX67922262OtherTRICARE, CHAMPUS, CO PAY SSI ALL INSURANCR
TXALLMedicaid