Provider Demographics
NPI:1578013314
Name:BAILEY, BRITTNEY (PA)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 122ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8398
Mailing Address - Country:US
Mailing Address - Phone:806-749-7975
Mailing Address - Fax:806-749-7937
Practice Address - Street 1:5028 122ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-749-7975
Practice Address - Fax:806-749-7937
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
TXPA10835363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant