Provider Demographics
NPI:1639701030
Name:MCDANIEL, BRITANEY
Entity Type:Individual
Prefix:
First Name:BRITANEY
Middle Name:
Last Name:MCDANIEL
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 1:18817 N HEATHERWILDE BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-1750
Mailing Address - Country:US
Mailing Address - Phone:512-523-4878
Mailing Address - Fax:512-870-9770
Practice Address - Street 1:1875 E CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-8490
Practice Address - Country:US
Practice Address - Phone:254-449-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty