MEDICARE: AMIE JOY HURON

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	164X00000X	Licensed Vocational Nurse	329542	TX

General Provider Information

NPI Number	:	1376338483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIE JOY HURON

Provider Business Mailing Address
First Line	:	16922 VISTA BLF DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4659
Country	:	US
Telephone Number	:	210-618-5375
Fax Number	:

Provider Business Practice Location Address
First Line	:	16019 NACOGDOCHES RD STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-1128
Country	:	US
Telephone Number	:	210-967-2800
Fax Number	:	210-443-0324

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

Provider Enumeration Date	:	04/10/2025
Last Update Date	:	04/10/2025

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