MEDICARE: MACBARBARA AMAECHI PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN-213474	MT
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G160510	IA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	C-APN.0100464-C-NP	CO
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	61755	NM
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1003974	TX
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61098624	WA

General Provider Information

NPI Number	:	1538632336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACBARBARA AMAECHI PMHNP

Provider Business Mailing Address
First Line	:	77 SUGAR CREEK CENTER BLVD STE 600
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3688
Country	:	US
Telephone Number	:	832-400-1002
Fax Number	:	832-410-3353

Provider Business Practice Location Address
First Line	:	5614 W GRAND PKWY S STE 102
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5820
Country	:	US
Telephone Number	:	832-400-1002
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	08/11/2024

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