Individual
MRS. MISTY M BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OM
Contact information
Practice address
106 E HERITAGE DR STE 5E, TYLER, TX 75703-5112
(903) 245-8667
(903) 595-4639
Mailing address
106 E HERITAGE DR STE 5E, TYLER, TX 75703-5112
(903) 245-8667
(903) 595-4639
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7882
TX
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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