Provider Demographics
NPI:1699255026
Name:HOWARD, AMANDA VICTORIA (LPTA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:VICTORIA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12807 SOUTHERN MANOR DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3673
Mailing Address - Country:US
Mailing Address - Phone:832-265-3261
Mailing Address - Fax:
Practice Address - Street 1:2750 MILLER RANCH RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9763
Practice Address - Country:US
Practice Address - Phone:713-770-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2128392225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant