Provider Demographics
NPI:1154638633
Name:MCINIS, AMANDA KATE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:KATE
Last Name:MCINIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 NORTH FWY STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-2919
Mailing Address - Country:US
Mailing Address - Phone:713-697-9315
Mailing Address - Fax:713-697-9386
Practice Address - Street 1:4615 NORTH FWY STE 310
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-2919
Practice Address - Country:US
Practice Address - Phone:713-697-9315
Practice Address - Fax:713-697-9386
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11549111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition