Provider Demographics
NPI:1437689726
Name:HARRIS, BRIDGETTE D
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 166781
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75016-6781
Mailing Address - Country:US
Mailing Address - Phone:972-510-4736
Mailing Address - Fax:
Practice Address - Street 1:4571 N. O'CONNOR RD
Practice Address - Street 2:1324
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3737
Practice Address - Country:US
Practice Address - Phone:972-510-4736
Practice Address - Fax:972-474-3300
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56740102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst