Individual
DR. AMANDA MANSOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4701 MONTEREY OAKS BLVD APT 325, NOT A PHYSICAL LOCATION, AUSTIN, TX 78749-1083
(865) 274-1074
Mailing address
4701 MONTEREY OAKS BLVD APT 325, AUSTIN, TX 78749-1083
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
62255
TN
Other
Enumeration date
06/10/2016
Last updated
06/19/2023
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