NPIMap

Organization Active NPI

Bridlewood Family Healthcare, P.a.

  • Primary Care Clinic/Center
  • Flower Mound, TX
National Provider Identifier
1821218652
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BRIDLEWOOD FAMILY HEALTHCARE, P.A.
Practice address
3400 Long Prairie Road
Suite 200
Flower Mound, TX 75022-2706
Phone
(972) 899-6300
Fax
(972) 899-6020
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian D Glaser, D.O.NPI 1083672067
Title
Owner
Phone
(972) 899-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X TX Primary

Addresses

Primary practice location

3400 Long Prairie Road
Suite 200
Flower Mound, TX 75022-2706

Mailing address

3400 Long Prairie Road
Suite 200
Flower Mound, TX 75022-2706
Phone (972) 899-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526001581 TX Part B Supplier - Clinic/Group Practice 9234110164 Receives reassigned benefits from 16 practitioners
Practice locations: Flower Mound, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1021335Bridlewood Family Healthcare3400 Long Prairie Road Suite 200, Flower Mound, TX 75022Certificate of waiverNov 19, 2027
45D2176595Bridlewood Family Healthcare3400 Long Prairie Rd Suite 102, Flower Mound, TX 75022Certificate of waiverDec 17, 2027

National Provider Directory

National Provider Directory

Locations

3051 Churchill Dr
Ste 100
Flower Mound, TX 75022
Phone (972) 410-3682

2560 Central Park Ave
Ste 140
Flower Mound, TX 75028
Phone (972) 410-3803

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821218652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LONG PRAIRIE ROAD",
            "address_2": "SUITE 200",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222706",
            "telephone_number": "972-899-6300",
            "fax_number": "972-899-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LONG PRAIRIE ROAD",
            "address_2": "SUITE 200",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222706",
            "telephone_number": "972-899-6300",
            "fax_number": "972-899-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDLEWOOD FAMILY HEALTHCARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-899-6300",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.