Provider Demographics
NPI:1396098984
Name:DEVERAUX, BRITTANY WELLS (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:WELLS
Last Name:DEVERAUX
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:MICHELLE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD
Mailing Address - Street 2:300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3077
Mailing Address - Country:US
Mailing Address - Phone:512-478-8116
Mailing Address - Fax:
Practice Address - Street 1:1301 BARBARA JORDAN BLVD
Practice Address - Street 2:300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3077
Practice Address - Country:US
Practice Address - Phone:512-478-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant