Provider Demographics
NPI:1366492266
Name:AMARO, VICTOR
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:AMARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 S. W. 4TH
Mailing Address - Street 2:P.O. BOX 1185
Mailing Address - City:PREMONT
Mailing Address - State:TX
Mailing Address - Zip Code:78375
Mailing Address - Country:US
Mailing Address - Phone:713-305-2658
Mailing Address - Fax:
Practice Address - Street 1:344 S. W. 4TH
Practice Address - Street 2:
Practice Address - City:PREMONT
Practice Address - State:TX
Practice Address - Zip Code:78375
Practice Address - Country:US
Practice Address - Phone:713-305-2658
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor