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NPI Code Detail

MEDICARE: ANDREA LISSETTE AMING PT, DPT

MEDICARE:   ANDREA LISSETTE AMING  PT, DPT
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
1225100000XPhysical Therapist1334383TX

General Provider Information

NPI Number : 1952900607
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LISSETTE AMING PT, DPT
Provider Business Mailing Address
First Line : 1512 BRYAN ST
Second Line :
City : EAGLE PASS
State : TX
Zip : 78852-4914
Country : US
Telephone Number : 832-674-5918
Fax Number :
Provider Business Practice Location Address
First Line : 2712 BEE CAVES RD STE 110
Second Line :
City : AUSTIN
State : TX
Zip : 78746-5662
Country : US
Telephone Number : 512-732-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2020
Last Update Date : 05/14/2021

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Directions to “ ANDREA LISSETTE AMING PT, DPT” Practice Location

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