Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 3032 | TX |
Y | 213ES0131X | Foot Surgery | 3032 | TX |
NPI | 1346761665 |
---|---|
Provider Name | Dr. Rayven Leigh Bridges |
First Address | Houston, TX 77002-8301 |
Second Address | Katy, TX 77494-3393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2017 |
Last Update Date | 08/12/2020 |