Provider Demographics
NPI:1619209434
Name:KOVALIC, BRITTANY ELISE X (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:ELISE
Last Name:KOVALIC
Suffix:X
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:12230 COIT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2322
Mailing Address - Country:US
Mailing Address - Phone:214-252-7020
Mailing Address - Fax:214-252-7025
Practice Address - Street 1:12230 COIT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2322
Practice Address - Country:US
Practice Address - Phone:214-252-7020
Practice Address - Fax:214-252-7025
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2016-01-05
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Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant