Healthcare Provider Details

I. General information

NPI: 1336739598
Provider Name (Legal Business Name): AMANDA MARIE STRATFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 BERTNER AVE
HOUSTON TX
77030-2604
US

IV. Provider business mailing address

3092 CAMDEN PARK LN
LEAGUE CITY TX
77573-7175
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-1000
  • Fax:
Mailing address:
  • Phone: 303-345-1945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1007955
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: