Basic Information
| Provider Information | |||||||||
| NPI: | 1023451200 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BANKHEAD | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | KAY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 EDGEBROOK AVE | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762488311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176944089 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3601 4TH ST | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794308311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067432373 | ||||||||
| FaxNumber: | 8067434354 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2013 | ||||||||
| LastUpdateDate: | 08/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | BP10046348 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | T4709 | TX | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.