Healthcare Provider Details

I. General information

NPI: 1669053674
Provider Name (Legal Business Name): ZACHARY DAVID BRITTINGHAM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 KYLE PKWY
KYLE TX
78640-6112
US

IV. Provider business mailing address

1621 E 6TH ST APT 1242
AUSTIN TX
78702-3350
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7000
  • Fax:
Mailing address:
  • Phone: 410-382-8082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDO2023-1085
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number00001
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: