Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | C19-0001 | AR |
N | 111NI0900X | Internist | C19-0001 | AR |
Y | 207RH0002X | Hospice and Palliative Medicine | T2535 | TX |
NPI | 1275069981 |
---|---|
Provider Name | Amanda Abbott |
First Address | Rowlett, TX 75088-4552 |
Second Address | Rowlett, TX 75088-4552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2017 |
Last Update Date | 18/10/2021 |