Individual
AMANDA MARIE ELLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
25723 OLD FREDERICKSBURG RD, BOERNE, TX 78015-6605
(210) 450-6800
Mailing address
25723 OLD FREDERICKSBURG RD, BOERNE, TX 78015-6605
(210) 450-6800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11103
TX
Other
Enumeration date
04/20/2017
Last updated
11/02/2023
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