Basic Information
Provider Information
NPI: 1558036392
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERNSTEIN
FirstName: BRITTANY
MiddleName:  
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Credential:  
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Mailing Information
Address1: TEXAS HEALTH CARE, PLLC DBA PRIVIA MEDICAL GROUP N P.O.
Address2: P.O. BOX 961205
City: FORT WORTH
State: TX
PostalCode: 761611205
CountryCode: US
TelephoneNumber: 8177408450
FaxNumber:  
Practice Location
Address1: 1250 8TH AVE STE 440
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761044144
CountryCode: US
TelephoneNumber: 8175028484
FaxNumber: 8179212701
Other Information
ProviderEnumerationDate: 08/13/2021
LastUpdateDate: 08/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X900000TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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