Provider Demographics
NPI:1013033018
Name:WOLFORD, AMY JEAN (APN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:WOLFORD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14340 TORREY CHASE BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1021
Mailing Address - Country:US
Mailing Address - Phone:281-580-8086
Mailing Address - Fax:281-580-7129
Practice Address - Street 1:14340 TORREY CHASE BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1021
Practice Address - Country:US
Practice Address - Phone:281-580-8086
Practice Address - Fax:281-580-7129
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01404364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health