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Individual

AMANDA JO TEJERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
130 N DENTON TAP RD STE 140, COPPELL, TX 75019-2155
(469) 495-9130
Mailing address
2637 FAIRMONT DR, GRAND PRAIRIE, TX 75052-4009
(817) 964-8349

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F12190188
TX
363LF0000X
Family Nurse Practitioner
Primary
AP145004
TX

Other

Enumeration date
01/30/2020
Last updated
10/02/2025
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