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NPI Code Detail

MEDICARE: AMY L DELLENEY PA

MEDICARE: AMY L DELLENEY 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
1363A00000XPhysician AssistantPA03987TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356465421
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY L DELLENEY PA
Provider Business Mailing Address
First Line : 1318 E DULSE ST
Second Line :
City : TYLER
State : TX
Zip : 75701-7103
Country : US
Telephone Number : 903-372-9518
Fax Number :
Provider Business Practice Location Address
First Line : 20208 STATE HIGHWAY 155 S
Second Line :
City : FLINT
State : TX
Zip : 75762-5600
Country : US
Telephone Number : 903-825-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 04/10/2026

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Directions to “ AMY L DELLENEY PA” Practice Location

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