Individual
AMANDA MICHELLE BURDETT-CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
5137 OLD SPANISH TRL, BRYAN, TX 77807-7697
(979) 676-2697
Mailing address
5137 OLD SPANISH TRL, BRYAN, TX 77807-7697
(979) 676-2697
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
186098
TX
208000000X
Pediatrics Physician
186098
TX
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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