Provider Demographics
NPI:1386707883
Name:DO, MANDY (FNP)
Entity type:Individual
Prefix:MISS
First Name:MANDY
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2707
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78299-2707
Mailing Address - Country:US
Mailing Address - Phone:512-795-4344
Mailing Address - Fax:
Practice Address - Street 1:7005 MIRA LOMA LN
Practice Address - Street 2:SUITE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1411
Practice Address - Country:US
Practice Address - Phone:512-795-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily