Healthcare Provider Details

I. General information

NPI: 1568853299
Provider Name (Legal Business Name): AMANDA CHIAO AUD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA RODRIGUEZ AUD, PHD

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

3117 COPPER AVE
EL PASO TX
79930-4329
US

V. Phone/Fax

Practice location:
  • Phone: 915-298-5444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80695
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number81463
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number81463
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: