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NPI Code Detail

MEDICARE: AMANDA ABBOTT D.O.

MEDICARE: AMANDA ABBOTT D.O.
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
1207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianT2535TX
2207R00000XInternal Medicine PhysicianC19-0001AR
3390200000XStudent in an Organized Health Care Education/Training Program
4390200000XStudent in an Organized Health Care Education/Training ProgramTX

General Provider Information

NPI Number : 1275069981
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ABBOTT D.O.
Provider Business Mailing Address
First Line : 950 W BETHANY DR STE 570
Second Line :
City : ALLEN
State : TX
Zip : 75013-3845
Country : US
Telephone Number : 844-593-1570
Fax Number :
Provider Business Practice Location Address
First Line : 4849 W LAWTHER DR
Second Line :
City : DALLAS
State : TX
Zip : 75214-1879
Country : US
Telephone Number : 214-651-4038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2017
Last Update Date : 04/24/2026

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