Provider Demographics
NPI:1891040705
Name:STAGER, BRITTANY KRISTINE (PT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KRISTINE
Last Name:STAGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:KRISTINE
Other - Last Name:GAILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1611 HEADWAY CIR
Mailing Address - Street 2:BUILDING 02
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5160
Mailing Address - Country:US
Mailing Address - Phone:512-615-6856
Mailing Address - Fax:
Practice Address - Street 1:1611 HEADWAY CIR
Practice Address - Street 2:BUILDING 02
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5160
Practice Address - Country:US
Practice Address - Phone:512-615-6856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1219756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist