Individual
AMANDA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 CAMINO LA COSTA, AUSTIN, TX 78752-3930
(512) 478-4939
Mailing address
2325 BRAVO CT, LEANDER, TX 78641-4180
(512) 584-5899
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1129842
TX
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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