Healthcare Provider Details

I. General information

NPI: 1417328261
Provider Name (Legal Business Name): BRITNI LEHDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MEMORIAL DR
BRYAN TX
77802-5205
US

IV. Provider business mailing address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

V. Phone/Fax

Practice location:
  • Phone: 979-731-4520
  • Fax: 979-596-5853
Mailing address:
  • Phone: 361-694-5311
  • Fax: 361-808-2069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP129396
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: