Provider Demographics
NPI:1932339132
Name:SWEENEY GOTSCH, BRIDGET M (MD)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:SWEENEY GOTSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:M
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7400 FANNIN ST STE 810
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1935
Mailing Address - Country:US
Mailing Address - Phone:713-512-8500
Mailing Address - Fax:
Practice Address - Street 1:200 BLOSSOM ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4204
Practice Address - Country:US
Practice Address - Phone:409-772-3695
Practice Address - Fax:409-772-3680
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5657208000000X, 208M00000X
IL036122408208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036122408Medicaid
ILPENDINGMedicare PIN