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General NPI Number Information
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NPI Number | 1356938583
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Entity Type | Individual
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Provider Name | BROOKEANA RENEE PIATT PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 950 N 19TH ST STE 200
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City | ABILENE
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State | TX
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Zip | 79601-2420
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Country | US
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Telephone | 325-670-5320
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 CONRAD HILTON BLVD
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City | CISCO
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State | TX
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Zip | 76437-3836
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Country | US
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Telephone | 325-660-6846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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