Provider Demographics
NPI:1396224416
Name:HAYMOND, BRITNEY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:HAYMOND
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 1:3460 RIVERSTONE CT APT 1323
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-0904
Mailing Address - Country:US
Mailing Address - Phone:915-449-4529
Mailing Address - Fax:
Practice Address - Street 1:2620 LONG PRAIRIE RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4953
Practice Address - Country:US
Practice Address - Phone:972-221-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12146363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant