Provider Demographics
NPI:1194469668
Name:WEST, AMANDA ROSE (MD)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ROSE
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:ALTENHOFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3500 GASTON AVENUE
Mailing Address - Street 2:HOBLITZELLE 102-OBGYN EDUCATION OFFICE
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 GASTON AVENUE
Practice Address - Street 2:HOBLITZELLE 102-OBGYN EDUCATION OFFICE
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-820-6378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program