Provider Demographics
NPI:1104857416
Name:TOWNSEND, AMY MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MICHELLE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1637
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77631
Mailing Address - Country:US
Mailing Address - Phone:409-883-1148
Mailing Address - Fax:409-883-1408
Practice Address - Street 1:608 STRICKLAND DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4717
Practice Address - Country:US
Practice Address - Phone:409-883-1148
Practice Address - Fax:409-883-1408
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3098207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189524501Medicaid
TXP00374421OtherRAILROAD MEDICARE
TX8W0550OtherBCBS
I61297Medicare UPIN
TX189524501Medicaid