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General NPI Number Information
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NPI Number | 1891777314
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Entity Type | Individual
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Provider Name | AMY L OFFUTT MD
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 707 3RD ST
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City | MARBLE FALLS
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State | TX
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Zip | 78654-5720
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Country | US
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Telephone | 830-693-7546
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Fax | 830-693-9194
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Provider Business Mailing Address
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Address Line | 707 3RD ST
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City | MARBLE FALLS
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State | TX
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Zip | 78654-5720
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Country | US
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Telephone | 830-693-7546
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Fax | 830-693-9194
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K6491
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License Number State | TX
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