Healthcare Provider Details

I. General information

NPI: 1487101572
Provider Name (Legal Business Name): BRITTANI BELL CST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANI BERRY CST

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CENTRAL EXPY N
ALLEN TX
75013-6103
US

IV. Provider business mailing address

9100 NATHANIEL DR
AUBREY TX
76227-1711
US

V. Phone/Fax

Practice location:
  • Phone: 918-955-5087
  • Fax:
Mailing address:
  • Phone: 918-955-5087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number179170
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number131069
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: