Healthcare Provider Details

I. General information

NPI: 1528685260
Provider Name (Legal Business Name): AMANDA AMSTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 RICHMOND AVE STE 110
HOUSTON TX
77046-3403
US

IV. Provider business mailing address

525 YALE ST APT 210
HOUSTON TX
77007-2862
US

V. Phone/Fax

Practice location:
  • Phone: 713-333-1770
  • Fax:
Mailing address:
  • Phone: 770-861-5589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberPA13756
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: