Individual
AMANDA M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11851 PHYSICIANS DR, EL PASO, TX 79936-6280
(915) 493-6646
Mailing address
11851 PHYSICIANS DR, EL PASO, TX 79936-6280
(915) 493-6646
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
1035160
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770047474
—
WI
Enumeration date
01/27/2019
Last updated
11/10/2025
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