Individual
AMANDA M VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
750 MID CITIES BLVD, STE 110, HURST, TX 76054-2792
(817) 581-2794
(817) 656-3659
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-4871
(682) 885-3639
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
80305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021184901
—
TX
01
—
1336198894
GROUP NPI NUMBER
—
Enumeration date
05/24/2010
Last updated
08/11/2010
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