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NPI Code Detail

MEDICARE: BRITTANY MICHELLE DEAVILA

MEDICARE: BRITTANY MICHELLE DEAVILA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2124538TX

General Provider Information

NPI Number : 1346720034
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY MICHELLE DEAVILA
Provider Business Mailing Address
First Line : 14182 CHARLES POLLOCK AVE
Second Line :
City : EL PASO
State : TX
Zip : 79938-3196
Country : US
Telephone Number : 915-637-4639
Fax Number :
Provider Business Practice Location Address
First Line : 10350 MONTANA AVE
Second Line :
City : EL PASO
State : TX
Zip : 79925-1602
Country : US
Telephone Number : 915-595-6137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 08/21/2018

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Directions to “ BRITTANY MICHELLE DEAVILA ” Practice Location

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