BRIDGETT D'ANN WALLACE (NPI# 1063451375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063451375 |
Entity Type | Individual |
Full Name | BRIDGETT D'ANN WALLACE |
Credential | PT |
Practice Address |
7900 Shoal Creek Blvd Suite 200 Austin TX 78757-8037 |
Mailing Address |
5608 Parkcrest Dr Ste 100 Austin TX 78731-4972 |
Practice Telephone | 5123454664 |
Practice Fax Number | 5123456150 |
Mailing Telephone | 5123454664 |
Mailing Fax Number | 5123456150 |
Enumeration Date | 2006-06-05 |
Last Update Date | 2019-01-31 |
Gender Code | F |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2251N0400X |
Physical Therapist Specialization: Neurology |
1104610 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | BCBS INDIVIDUAL # | 86683T | 01 |
TX | BCBS GROUP # | 0050HV | 01 |
TX | PHCS PROVIDER # | 030384821 | 01 |
TX | TEXAS TRUE CHOICE | 030384821 | 01 |
TX | HUMANA | 030384821 | 01 |
Street Address |
7900 SHOAL CREEK BLVD SUITE 200 |
City | AUSTIN |
State | TX |
Zip Code | 78757-8037 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528186764 | Sandra Kaye Wing | Physical Therapist | 7900 Shoal Creek Blvd, Suite 200, Austin, TX 78757-8037 | 2007-03-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518518927 | Mark D Newberry | Pharmacist | 8500 Shoal Creek Blvd Bldg 3 Ste 200, Austin, TX 78757 | 2019-09-26 |
1972063634 | Napa Center Usa, LLC | Physical Therapist | 8640 Burnet Rd, Austin, TX 78757 | 2019-03-20 |
1013493071 | Anna Cathleen Mccormack | Pharmacist | 2525 W Anderson Lane Bldg 2, Austin, TX 78757 | 2018-07-12 |
1336633379 | Claire Siegel | Dietitian, Registered | 7421 Burnet Rd # 269, Austin, TX 78757 | 2018-06-21 |
1619372687 | Krishna Gc | Nurse Practitioner | 7950 Anderson Square Suite 108, 225, Austin, TX 78757 | 2014-11-03 |
1447669874 | Nicholas Dale Taylor | Psychologist | 8500 Shoal Creek Blvd Ste 201, Austin, TX 78757 | 2014-08-11 |
1396155404 | Onsite Chiropractic, Pllc | Chiropractor | 1929 Payton Gin Rd., Ste E, Austin, TX 78757 | 2014-04-29 |
1578994703 | Greentree Health Pain Management | Pain Medicine | 8900 Shoal Creek Bvld, Bldg 200, Austin, TX 78757 | 2013-12-13 |
1457692139 | Harbor Hospice of Georgetown, Lp | Hospice Care, Community Based | 7800 Shoal Creek Boulevard, Suite 105n, Austin, TEXAS 78757 | 2013-03-06 |
1821335852 | Janet Lee Cook | Acupuncturist | 8303 Shoal Creek Boulevard, Austin, TX 78757 | 2013-01-10 |
Find all providers in zip 78757 |
Taxonomy Code | 2251N0400X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Neurology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972063634 | Napa Center Usa, LLC | Physical Therapist | 8640 Burnet Rd, Austin, TX 78757 | 2019-03-20 |
1780150953 | Hannah Karine Zabel | Physical Therapist | 919 E 32nd St, Austin, TX 78705-2703 | 2018-10-15 |
1598245235 | Kristel Kay Louis | Physical Therapist | 9050 N Capital of Texas Hwy Ste 130, Austin, TX 78759-7268 | 2018-08-21 |
1780018150 | Donna Abrameit | Physical Therapist | 5555 N Lamar Blvd, Ste L 103, Austin, TX 78751-1073 | 2013-08-21 |
1033357017 | Jeanne Broussard Ballinger | Physical Therapist | 5555 N Lamar Blvd, Ste L 103, Austin, TX 78751-1073 | 2009-01-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356973275 | Sunil Mathew | Physical Therapist | 3012 Double Creek Dr, Grapevine, TX 76051-4251 | 2020-02-08 |
1205317286 | Felicia Youngblood | Physical Therapist | 8615 Lullwater Dri, Dallas, TX 75238 | 2018-08-27 |
1982133799 | Alishia Lindsay Schmitt | Physical Therapist | 6913 Camp Bowie Blvd Ste 141, Fort Worth, TX 76116-7165 | 2017-06-06 |
1770953655 | Alicia Danto | Physical Therapist | 3601 N Macgregor Way Ste 512, Houston, TX 77004-8004 | 2015-10-05 |
1154737740 | Michael Furtado | Physical Therapist | 411 W 14th St, Houston, TX 77008-4111 | 2014-07-03 |
1801225289 | Zahra Kadivar | Physical Therapist | 11626 Royal Oaks Vw, Houston, TX 77082-2842 | 2013-11-05 |
1912247032 | Jesly Lopez | Physical Therapist | 12055 Sabo Rd Apt 1017, Houston, TX 77089-6290 | 2013-02-26 |
1164710943 | Joseph Gerard Rauma | Physical Therapist | 221 Rosa Ln, Nacogdoches, TX 75965-1911 | 2011-07-14 |
1013207802 | Terri Lynn Moore | Physical Therapist | 411 N Washington Ave Ste 4000, Dallas, TX 75246-1776 | 2011-04-13 |
1053628776 | Kelly Twohey-byrne | Physical Therapist | 4141 Sw Fwy Ste 100, Houston, TX 77027-7330 | 2010-09-01 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.