Provider Demographics
NPI:1386412336
Name:LETT, DARBY (PA-C)
Entity type:Individual
Prefix:
First Name:DARBY
Middle Name:
Last Name:LETT
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 1:17209 CEDAR ROCK CT UNIT B
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-9499
Mailing Address - Country:US
Mailing Address - Phone:210-241-9940
Mailing Address - Fax:
Practice Address - Street 1:2700 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2531
Practice Address - Country:US
Practice Address - Phone:979-774-4008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical