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Individual
AMANDA LISS
Active
Individual
AMANDA LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA10992
TX
363AS0400X
Surgical Physician Assistant
Primary
PA10992
TX
363AS0400X
Surgical Physician Assistant
PA2020-0029
NM
Other
Enumeration date
02/22/2017
Last updated
07/21/2022
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