Provider Demographics
NPI:1124532098
Name:BARBEE, AMANDA (MED, ATC, LAT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BARBEE
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13103 SOUTHERN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3793
Mailing Address - Country:US
Mailing Address - Phone:504-296-4296
Mailing Address - Fax:
Practice Address - Street 1:8779 GREENLEAVES DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6747
Practice Address - Country:US
Practice Address - Phone:504-296-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLAT51492255A2300X
LA3129332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer