Provider Demographics
NPI:1508374216
Name:BRINKLEY, ALICE
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:BRINKLEY
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 1:7231 PARK WEST CIR APT 205
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76134-3551
Mailing Address - Country:US
Mailing Address - Phone:817-879-9698
Mailing Address - Fax:
Practice Address - Street 1:7231 PARK WEST CIR APT 205
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76134-3551
Practice Address - Country:US
Practice Address - Phone:817-879-9698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health