Provider Demographics
NPI:1730688227
Name:JOSSERAND, AMELIA R (PA-C)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:R
Last Name:JOSSERAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:R
Other - Last Name:GOVERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5224 75TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2525
Mailing Address - Country:US
Mailing Address - Phone:806-712-1096
Mailing Address - Fax:806-771-2093
Practice Address - Street 1:10777 WESTHEIMER RD STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3462
Practice Address - Country:US
Practice Address - Phone:877-878-3289
Practice Address - Fax:877-817-3227
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13009363A00000X
NE2209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant