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NPI Code Detail

MEDICARE: AMANDA WELCH P.A.

MEDICARE: AMANDA WELCH P.A.
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 AssistantPA02774TX

General Provider Information

NPI Number : 1730222845
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA WELCH P.A.
Provider Business Mailing Address
First Line : PO BOX 35629
Second Line :
City : DALLAS
State : TX
Zip : 75235-0629
Country : US
Telephone Number : 214-424-2213
Fax Number : 214-231-2170
Provider Business Practice Location Address
First Line : 1850 LAKEPOINTE DR
Second Line : SUITE 400
City : LEWISVILLE
State : TX
Zip : 75057-6442
Country : US
Telephone Number : 972-316-0262
Fax Number : 972-316-8762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 05/28/2009

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