Individual
AMANDA PATTERSON WICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
808 KELLER PKWY, KELLER, TX 76248-2405
(817) 431-2573
(817) 379-6881
Mailing address
808 KELLER PKWY, KELLER, TX 76248-2405
(817) 431-2573
(817) 379-6881
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02797
TX
Other
Enumeration date
07/30/2007
Last updated
10/15/2010
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