Individual
AMBER RENEE MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3529 HERITAGE TRACE PKWY STE 137, FORT WORTH, TX 76244-4971
(817) 741-7960
(817) 741-7581
Mailing address
3529 HERITAGE TRACE PKWY STE 137, FORT WORTH, TX 76244-4971
(817) 741-7960
(817) 741-7581
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06954
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328209701
—
TX
Enumeration date
11/12/2010
Last updated
04/16/2019
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