Individual
AMY REYNE WENTWORTH-KOTARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 INWOOD RD, DALLAS, TX 75390
(214) 645-2800
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(214) 645-2800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05178
TX
Other
Enumeration date
03/08/2007
Last updated
08/19/2019
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