Provider Demographics
NPI:1083494850
Name:MYERS, AMANDA MARIA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIA
Last Name:MYERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIA
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 HOSPITAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6913
Mailing Address - Country:US
Mailing Address - Phone:817-848-4000
Mailing Address - Fax:
Practice Address - Street 1:1600 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6913
Practice Address - Country:US
Practice Address - Phone:817-848-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program