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Individual
AMY M POND
Active
Individual
AMY M POND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004085
OH
363A00000X
Physician Assistant
Primary
10001828A
IN
363A00000X
Physician Assistant
PA11421
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00106W
MEDICARE GRP PTAN #
TX
01
—
0035TD
BCBSTX GRP PRACTICE RECORD #
TX
01
—
153449704
MEDICAID GRP PRACTICE TPI #
TX
Enumeration date
09/04/2014
Last updated
11/30/2022
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