Healthcare Provider Details

I. General information

NPI: 1093644627
Provider Name (Legal Business Name): CARMEN NICOLE BRILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN NICOLE WESTBROOK

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 14TH AVE NW
ARDMORE OK
73401-1828
US

IV. Provider business mailing address

609 CROSSPOINT DR
NEW BRAUNFELS TX
78130-2695
US

V. Phone/Fax

Practice location:
  • Phone: 580-223-5400
  • Fax:
Mailing address:
  • Phone: 830-837-6450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: