Provider Demographics
NPI:1174102115
Name:CRAIG, BRITNEY (PA-C)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 WEMBLEY RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2328
Mailing Address - Country:US
Mailing Address - Phone:501-772-3130
Mailing Address - Fax:
Practice Address - Street 1:4255 PLEASANTVIEW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4304
Practice Address - Country:US
Practice Address - Phone:817-765-2104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9114104363A00000X
TXPA14493363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant