Provider Demographics
NPI:1124399092
Name:AMANDA A TROTT, MD PA
Entity type:Organization
Organization Name:AMANDA A TROTT, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TROTT-GREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-888-1297
Mailing Address - Street 1:255 E SONTERRA BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4076
Mailing Address - Country:US
Mailing Address - Phone:210-888-1297
Mailing Address - Fax:210-888-1285
Practice Address - Street 1:255 E SONTERRA BLVD STE 209
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4076
Practice Address - Country:US
Practice Address - Phone:210-888-1297
Practice Address - Fax:210-888-1285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty