Provider Demographics
NPI:1063743029
Name:OWENS, AMANDA B (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:OWENS
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:B
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, PA-C
Mailing Address - Street 1:3440 BELL ST
Mailing Address - Street 2:SUITE 122
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-4142
Mailing Address - Country:US
Mailing Address - Phone:806-379-9225
Mailing Address - Fax:806-331-4497
Practice Address - Street 1:3440 BELL ST
Practice Address - Street 2:SUITE 122
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-4142
Practice Address - Country:US
Practice Address - Phone:806-379-9225
Practice Address - Fax:806-331-4497
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant