MEDICARE: BRIANNA ELISE COLE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA19665	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA19665	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1376333096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA ELISE COLE PA-C

Provider Business Mailing Address
First Line	:	800 W MAGNOLIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4611
Country	:	US
Telephone Number	:	817-759-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD STE 102
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2084
Country	:	US
Telephone Number	:	817-759-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	12/05/2025

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Directions to “ BRIANNA ELISE COLE PA-C” Practice Location

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