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AMANDA SUZANNE ANUENUE MUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5228 W PLANO PKWY, PLANO, TX 75093-5005
(972) 250-5700
Mailing address
930 E 15TH ST APT 510, PLANO, TX 75074-5875
(972) 979-3983

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA15075
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA15075
TEXAS MEDICAL BOARD
TX
Enumeration date
10/28/2021
Last updated
10/28/2021
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