Provider Demographics
NPI:1831542208
Name:GOOS, BRITTANY ELISE (PTA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ELISE
Last Name:GOOS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10961 GATEWAY BLVD W
Mailing Address - Street 2:SUITE #100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4922
Mailing Address - Country:US
Mailing Address - Phone:915-245-3131
Mailing Address - Fax:
Practice Address - Street 1:10961 GATEWAY BLVD W
Practice Address - Street 2:SUITE #100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4922
Practice Address - Country:US
Practice Address - Phone:915-245-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2121939225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant