person
Amanda Isabel Licea, PA-C
Medical Physician Assistant in Austin, Texas
NPI 1609110683

Amanda Isabel Licea is a Medical Physician Assistant based in Austin, TX and is specialized in Medical. Amanda Isabel Licea practices in Austin, TX and has the professional credentials of PA-C. The NPI Number for Amanda Isabel Licea is 1609110683 and holds a License No. PA08169 (Texas).

The current practice location address for Amanda Isabel Licea is 608 Radam Ln, Austin, TX and can be reached out via phone at 512-443-5988 and via fax at 512-443-5055. You can also correspond with Amanda Isabel Licea through the mailing address at 8240 N MOPAC EXPY STE 100, AUSTIN, TX - 78759-8869 (mailing address contact number: 512-687-1950).

Location: 608 Radam Ln, Austin, TX, 78759-8869
person
Provider Profile Details
NPI Number
1609110683
Provider Name
Amanda Isabel Licea
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
608 Radam Ln, Austin, TX, 78759-8869
Phone Number
512-443-5988
Fax Number
512-443-5055
Provider Enumeration Date
11/15/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
608 Radam Ln
City
State
Zip
78745-1172
Phone Number
512-443-5988
Fax Number
512-443-5055
person
Provider Business Mailing Address Details
Address
608 Radam Ln
City
State
Zip
78745-1172
Phone Number
512-443-5988
Fax Number
512-443-5055
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA08169 (Texas)
Definition
Definition to come...
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