MEDICARE: AMANDA PERES PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA20354	TX

General Provider Information

NPI Number	:	1043147960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA PERES PA-C

Provider Business Mailing Address
First Line	:	6925 ESTANA LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739-2112
Country	:	US
Telephone Number	:	214-733-1858
Fax Number	:

Provider Business Practice Location Address
First Line	:	6925 ESTANA LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739-2112
Country	:	US
Telephone Number	:	214-733-1858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ AMANDA PERES PA-C” Practice Location

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