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General NPI Number Information
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NPI Number | 1124655345
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Entity Type | Individual
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Provider Name | AMANDA M MEUSBORN
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Gender | Female
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 3325 PATE WAY
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City | ANNA
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State | TX
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Zip | 75409-8459
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Country | US
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Telephone | 972-838-2602
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 PINE CT
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1292
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Country | US
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Telephone | 417-466-8130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | 1264195
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License Number State | TX
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