Individual
AMANDA ROSE VERDEYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 W COLLEGE ST, GRAPEVINE, TX 76051-3565
(817) 481-1588
Mailing address
1650 W COLLEGE ST, GRAPEVINE, TX 76051-3565
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
Q3460
TX
Other
Enumeration date
04/06/2011
Last updated
02/16/2017
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