Organization
BRIDGESIDE TELEHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BRADDOCK (CEO)
(817) 395-6284
Entity
Organization
Contact information
Practice address
2009 TREMONT AVE, FORT WORTH, TX 76107-3959
(817) 395-6284
Mailing address
2009 TREMONT AVE, FORT WORTH, TX 76107-3959
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/28/2022
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