Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11549 | TX |
N | 111NN1001X | Nutrition | 11549 | TX |
NPI | 1154638633 |
---|---|
Provider Name | Dr. Amanda Kate Mcinis |
First Address | Houston, TX 77022-2919 |
Second Address | Houston, TX 77022-2919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2010 |
Last Update Date | 03/08/2020 |