Individual
AMANDA AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP-PC
Contact information
Practice address
4405 RIVER OAKS BLVD, FORT WORTH, TX 76114-2326
(817) 624-1770
(817) 625-1287
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
1048716
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
1048716
TX
Other
Enumeration date
02/22/2022
Last updated
05/06/2022
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