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Individual

AMY METTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
660 W SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6069
(817) 416-9731
(817) 416-9751
Mailing address
660 W SOUTHLAKE BLVD., SUITE 100, SOUTHLAKE, TX 76092-6070
(817) 416-9731
(817) 416-9751

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
N5868
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP1-0026060
INSTITUTIONAL PERMIT
Enumeration date
06/09/2007
Last updated
10/13/2011
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