Provider Demographics
NPI:1326464769
Name:THOMAS, AMANDA B (PA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:K
Other - Last Name:BUELOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5929 BALCONES DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4280
Mailing Address - Country:US
Mailing Address - Phone:512-550-1800
Mailing Address - Fax:855-828-0878
Practice Address - Street 1:9191 KYSER WAY STE A
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1902
Practice Address - Country:US
Practice Address - Phone:972-716-3922
Practice Address - Fax:855-828-0878
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
TXPA08823363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant