Vancy Howard Bridges, M.D.
Individual provider Active NPI Family Medicine Physician · Euless, TX
NPI 1982644548 · NPPES record last updated Jul 16, 2013
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective May 19, 2022.
Key facts
- NPI
- 1982644548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G7788 (TX)
- Practice address
- 1629 Brook Grove Dr
Euless, TX 76039-5269 - Phone
- (214) 830-1057
- Fax
- (214) 988-2505
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G7788 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shepherds Gate Life Changing Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G7788 | TX | Yes |
Addresses
Primary practice location
1629 Brook Grove Dr
Euless, TX 76039-5269
Mailing address
1629 Brook Grove Dr
Euless, TX 76039-5269
Phone (214) 830-1057
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046271505 | Medicaid | TX |
Other providers in Euless, TX
- Bodyworks Chiropractic PLLC
- Joseph Russell Bonsness
- Kaitlyn Danielle Bradley
- Bravo Dental
- Bravo Smiles
- Todd Allen Bright
- Brightpath BPSR LLC
- Candy C. Brooks
- Brown Advocacy & Empowerment PLLC
- Martaya Brown
All providers in Euless, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.