Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 730502 | TX |
NPI | 1023358785 |
---|---|
Provider Name | Claudia Lizeth Amador |
First Address | Victoria, TX 77901-6502 |
Second Address | Victoria, TX 77901-6502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2013 |
Last Update Date | 20/06/2014 |