MEDICARE: AMMA MEDICAL GROUP PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1710814298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMMA MEDICAL GROUP PA

Provider Business Mailing Address
First Line	:	2109 E 8TH ST UNIT A
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-3433
Country	:	US
Telephone Number	:	210-363-5601
Fax Number	:

Provider Business Practice Location Address
First Line	:	2109 E 8TH ST UNIT A
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-3433
Country	:	US
Telephone Number	:	210-363-5601
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	JESSICA LORENZANA
Credential	:	MD
Telephone Number	:	210-363-5601

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/11/2026

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Directions to “AMMA MEDICAL GROUP PA ” Practice Location

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