MEDICARE: BRITTANY BREWER

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1629536552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY BREWER

Provider Business Mailing Address
First Line	:	1103 FAIRHAVEN DR
Second Line	:
City	:	GLENN HEIGHTS
State	:	TX
Zip	:	75154-0074
Country	:	US
Telephone Number	:	214-335-2098
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 W MOCKINGBIRD LN STE 1030
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-5028
Country	:	US
Telephone Number	:	972-489-5552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	03/11/2019

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