| The Bridge | |
|
1818 Corsicana St Dallas TX 75201-6102 | |
| (214) 266-0214 | |
| Not Available |
| Full Name | The Bridge |
|---|---|
| Speciality | Clinic/Center |
| Location | 1818 Corsicana St, Dallas, Texas |
| Authorized Official Name and Position | Frederick P. Cerise (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2145908006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bridge Po Box 660599 Dallas TX 75266-0599 | The Bridge 1818 Corsicana St Dallas TX 75201-6102 Ph: (214) 266-0214 |
| NPI Number | 1861853004 |
|---|---|
| Provider Enumeration Date | 03/16/2016 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Medicare PECOS PAC ID | 8325934813 |
|---|---|
| Medicare Enrollment ID | O20130903000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861853004 | NPI | - | NPPES |
| 335989502 | Medicaid | TX | |
| 335989501 | Medicaid | TX |
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