Provider Demographics
NPI:1386740645
Name:WALSH, AMY SUSAN (DPM)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:SUSAN
Last Name:WALSH
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:8681 LOUETTA RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6681
Mailing Address - Country:US
Mailing Address - Phone:281-370-0648
Mailing Address - Fax:281-251-3350
Practice Address - Street 1:8681 LOUETTA RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6681
Practice Address - Country:US
Practice Address - Phone:281-370-0648
Practice Address - Fax:281-251-3350
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1475213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044994402Medicaid
TX75770Medicare UPIN
TX8F23773Medicare PIN