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NPI Code Detail

MEDICARE: MISS AMANDA LEA MATTHEWS PA

MEDICARE: MISS AMANDA LEA MATTHEWS PA
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
1363AM0700XMedical Physician AssistantPA14456TX

General Provider Information

NPI Number : 1265789598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS AMANDA LEA MATTHEWS PA
Provider Business Mailing Address
First Line : 4751 HAMILTON WOLFE RD STE 200
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3458
Country : US
Telephone Number : 210-233-7126
Fax Number :
Provider Business Practice Location Address
First Line : 4751 HAMILTON WOLFE RD STE 200
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3458
Country : US
Telephone Number : 210-233-7126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2012
Last Update Date : 11/07/2023

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Directions to “ MISS AMANDA LEA MATTHEWS PA” Practice Location

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