Bridgett D'ann Wallace
Physical Therapist - Neurology
7900 Shoal Creek Blvd Suite 200
Austin
, Texas 78757-8037
Bridgett D'ann Wallace
Physical Therapist - Neurology
7900 Shoal Creek Blvd Suite 200
Austin
, Texas 78757-8037
(512) 345-6150
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About
Features
Specialties
- Physical Therapist - Neurology
Languages spoken
- English
Location
First Address
- Bridgett D'ann Wallace
- 5608 Parkcrest Dr Ste 100
- Austin, TX
- Zip : 78731-4972
- Fax : (512) 345-6150
- Phone : (512) 345-4664
Second Address
- Bridgett D'ann Wallace
- 7900 Shoal Creek Blvd Suite 200
- Austin, TX
- Zip : 78757-8037
- Fax : (512) 345-6150
- Phone : (512) 345-4664
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251N0400X | Physical Therapist - Neurology | 1104610 | TX |
National Provider Identifier
| NPI | 1063451375 |
|---|---|
| Provider Name | Bridgett D'ann Wallace |
| First Address | Austin, TX 78731-4972 |
| Second Address | Austin, TX 78757-8037 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/06/2006 |
| Last Update Date | 31/01/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0050HV | BCBS GROUP # (01) | TX |
| 030384821 | HUMANA (01) | TX |
| 030384821 | PHCS PROVIDER # (01) | TX |
| 030384821 | TEXAS TRUE CHOICE (01) | TX |
| 86683T | BCBS INDIVIDUAL # (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.