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Individual
KEITH MYCAL BRIDGES
Active
Individual
KEITH MYCAL BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
895421
TX
363LF0000X
Family Nurse Practitioner
Primary
1126443
TX
Other
Enumeration date
02/19/2021
Last updated
06/05/2024
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