Individual
AMANDA DISARRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9805 BRODIE LN, AUSTIN, TX 78748-5610
(512) 462-1936
(833) 448-3184
Mailing address
9805 BRODIE LN, AUSTIN, TX 78748-5610
(512) 462-1936
(833) 448-3184
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
191682
NC
207VX0000X
Obstetrics Physician
Primary
R1738
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74-2922251
—
TX
Enumeration date
04/30/2013
Last updated
02/02/2024
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