MEDICARE: REBECCA BRIGGS

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	183500000X	Pharmacist	50415	TX

General Provider Information

NPI Number	:	1538448022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BRIGGS

Provider Business Mailing Address
First Line	:	5331 E MOCKINGBIRD LN APT 537
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-0910
Country	:	US
Telephone Number	:	254-495-8902
Fax Number	:

Provider Business Practice Location Address
First Line	:	5331 E MOCKINGBIRD LN APT 537
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206
Country	:	US
Telephone Number	:	254-495-8902
Fax Number	:

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

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	10/14/2018

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