Individual
DR. AMANDA WITT NUNLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
902 KITTY HAWK RD, SUITE 110, UNIVERSAL CITY, TX 78148-3825
(210) 659-0889
Mailing address
2232 OAK VLY, SCHERTZ, TX 78154-1974
(210) 863-6693
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
BP1-0029052
TX
207Q00000X
Family Medicine Physician
Primary
N5913
TX
207V00000X
Obstetrics & Gynecology Physician
BP1-0029052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R90C
GROUP PTAN 00R90C
TX
01
—
TXB125053
MEDICARE PTAN
TX
Enumeration date
07/02/2008
Last updated
11/17/2021
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