Provider Demographics
NPI:1336649995
Name:MING, AMANDA BETH (DC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BETH
Last Name:MING
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 1:2000 S IH 35 STE H-1
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-6900
Mailing Address - Country:US
Mailing Address - Phone:125-733-1700
Mailing Address - Fax:
Practice Address - Street 1:2000 S IH 35 STE H-1
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:125-733-1700
Practice Address - Fax:512-733-1713
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor