Individual
AMANDA SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555
(409) 772-2166
(409) 772-2663
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-1385
(409) 772-2166
(409) 772-2663
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
BP10064480
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2018
Last updated
06/28/2021
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