Provider Demographics
NPI:1275282089
Name:COVIN, BRIANNA DANIELLE (MD)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:DANIELLE
Last Name:COVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:DANIELLE
Other - Last Name:BASINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 S 31ST ST # MS -01712
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508-0001
Mailing Address - Country:US
Mailing Address - Phone:254-724-2366
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST # MS -01712
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program