Individual
MISS AMANDA AMINA KHORDAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
734 NORTH LOOP, HOUSTON, TX 77009-1043
(713) 868-2766
(713) 868-7575
Mailing address
21122 BRIDGE FALLS CT, KATY, TX 77449-5067
(832) 623-4107
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2119733
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119733
BCBS
TX
Enumeration date
02/16/2019
Last updated
09/08/2022
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