| Bridlewood Family Healthcare, P.a. | |
|
3400 Long Prairie Road Suite 200 Flower Mound TX 75022-2706 | |
| (972) 899-6300 | |
| (972) 899-6020 |
| Full Name | Bridlewood Family Healthcare, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3400 Long Prairie Road, Flower Mound, Texas |
| Authorized Official Name and Position | Brian D Glaser (OWNER) |
| Authorized Official Contact | 9728996300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridlewood Family Healthcare, P.a. 3400 Long Prairie Road Suite 200 Flower Mound TX 75022-2706 Ph: (972) 899-6300 | Bridlewood Family Healthcare, P.a. 3400 Long Prairie Road Suite 200 Flower Mound TX 75022-2706 Ph: (972) 899-6300 |
| NPI Number | 1821218652 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9234110164 |
|---|---|
| Medicare Enrollment ID | O20040526001581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821218652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Texas) | Primary |
| Provider Name | Paul J Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710075239 PECOS PAC ID: 4385634161 Enrollment ID: I20040513001389 |
| Provider Name | Brian D Glaser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083672067 PECOS PAC ID: 1355238031 Enrollment ID: I20040526001606 |
| Provider Name | Bryan L Wasson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972537801 PECOS PAC ID: 3375679301 Enrollment ID: I20100330000363 |
| Provider Name | Victoria V Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124412770 PECOS PAC ID: 3375863111 Enrollment ID: I20150519002444 |
| Provider Name | April C Yanez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417466947 PECOS PAC ID: 5193081503 Enrollment ID: I20171116003167 |
| Provider Name | Kelly Monica Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568856730 PECOS PAC ID: 8325308695 Enrollment ID: I20180206000109 |
| Provider Name | Heather Dawn Darwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841762861 PECOS PAC ID: 6608101100 Enrollment ID: I20190703002426 |
| Provider Name | Bijal Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134755838 PECOS PAC ID: 6406256502 Enrollment ID: I20210610003125 |
| Provider Name | Courtenay Traverse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508458720 PECOS PAC ID: 1052705316 Enrollment ID: I20220302001580 |
| Provider Name | Whitney Seeber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346834967 PECOS PAC ID: 2062807571 Enrollment ID: I20220321001013 |
| Provider Name | Piava Rioli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679037329 PECOS PAC ID: 0941548770 Enrollment ID: I20220323002620 |
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