Provider Demographics
NPI:1154942530
Name:MACHA, AMANDA FLORES (OT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:FLORES
Last Name:MACHA
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 VANGUARD RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706-2974
Mailing Address - Country:US
Mailing Address - Phone:682-206-5520
Mailing Address - Fax:
Practice Address - Street 1:4010 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-2233
Practice Address - Country:US
Practice Address - Phone:432-614-0268
Practice Address - Fax:888-972-6512
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
TX119661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist