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NPI Code Detail

MEDICARE: DR. AMANDA LEIGH POLLITT DO

MEDICARE: DR. AMANDA LEIGH POLLITT DO
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
1207Q00000XFamily Medicine PhysicianQ0996TX
2207Q00000XFamily Medicine Physician710NE

General Provider Information

NPI Number : 1407018559
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA LEIGH POLLITT DO
Provider Business Mailing Address
First Line : 4240 SOUTHWEST BLVD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-5634
Country : US
Telephone Number : 325-658-6138
Fax Number :
Provider Business Practice Location Address
First Line : 4240 SOUTHWEST BLVD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-5634
Country : US
Telephone Number : 325-658-6138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2008
Last Update Date : 06/10/2021

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Directions to “ DR. AMANDA LEIGH POLLITT DO” Practice Location

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