Individual
DR. AMY MYNDERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 SUNSET BLVD, HOUSTON, TX 77005-1713
(713) 526-5511
(713) 520-4755
Mailing address
PO BOX 4767, HOUSTON, TX 77210-4767
(713) 526-5511
(713) 520-4755
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M2721
TX
208M00000X
Hospitalist Physician
M2721
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182194401
—
TX
01
—
8V3667
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
—
P00359984
RAILROAD MEDICARE
TX
Enumeration date
07/07/2006
Last updated
02/09/2016
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