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Individual

MS. AMBER ANISE MICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A

Contact information

Practice address
3201 UNIVERSITY DR. E, STE 205, BRYAN, TX 77802-3482
(979) 774-7896
(979) 776-5264
Mailing address
3201 UNIVERSITY DR E, STE 205, BRYAN, TX 77802-3482
(979) 774-7896
(979) 776-5264

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00745
TX
363AM0700X
Medical Physician Assistant
PA00745
TX

Other

Enumeration date
10/04/2006
Last updated
03/15/2012
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