Provider Demographics
NPI:1326519059
Name:BURDITT, BRITTNEY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:BURDITT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 HOOD ST APT 306
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4883
Mailing Address - Country:US
Mailing Address - Phone:832-622-6294
Mailing Address - Fax:
Practice Address - Street 1:2510 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1410
Practice Address - Country:US
Practice Address - Phone:469-789-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12481363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant