Dr. Amanda Nicole Long
Endocrinologist (Diabetes Doctor)
619 S Fleishel Ave Ste 327
Tyler
, Texas 75701-2004
Dr. Amanda Nicole Long
Endocrinologist (Diabetes Doctor)
619 S Fleishel Ave Ste 327
Tyler
, Texas 75701-2004
(903) 324-6450
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About
Features
Specialties
- Endocrinologist (Diabetes Doctor)
Languages spoken
- English
Location
First Address
- Dr. Amanda Nicole Long
- Po Box 846098
- Dallas, TX
- Zip : 75284-6098
- Phone : (903) 324-6450
Second Address
- Dr. Amanda Nicole Long
- 619 S Fleishel Ave Ste 327
- Tyler, TX
- Zip : 75701-2004
- Phone : (903) 510-1173
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | P2894 | TX |
National Provider Identifier
| NPI | 1013129931 |
|---|---|
| Provider Name | Dr. Amanda Nicole Long |
| First Address | Dallas, TX 75284-6098 |
| Second Address | Tyler, TX 75701-2004 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/05/2007 |
| Last Update Date | 15/03/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 302066101 | (05) | TX |
| 752616977012 | TRICARE (01) | TX |
| 8DF550 | BCBS (01) | TX |
| P01081164 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.