Provider Demographics
NPI:1063145803
Name:MACEDO, BRITTANY LYNNE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNNE
Last Name:MACEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 GOLDERS GREEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-4910
Mailing Address - Country:US
Mailing Address - Phone:832-232-2488
Mailing Address - Fax:
Practice Address - Street 1:6011 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5386
Practice Address - Country:US
Practice Address - Phone:214-645-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program