Provider Demographics
NPI:1619218021
Name:BESONG, BRITTANY LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEE
Last Name:BESONG
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 1:6769 LAKE WOODLANDS DR STE E
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2771
Mailing Address - Country:US
Mailing Address - Phone:281-210-1200
Mailing Address - Fax:
Practice Address - Street 1:6769 LAKE WOODLANDS DR STE E
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2771
Practice Address - Country:US
Practice Address - Phone:281-210-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08215363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical