Provider Demographics
NPI:1467723510
Name:THORNTON, AMY CHANDLER (PA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHANDLER
Last Name:THORNTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1200 BINZ ST
Mailing Address - Street 2:SUITE 580
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6900
Mailing Address - Country:US
Mailing Address - Phone:713-526-2663
Mailing Address - Fax:713-521-1576
Practice Address - Street 1:7401 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4509
Practice Address - Country:US
Practice Address - Phone:713-799-2300
Practice Address - Fax:713-794-3395
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2020-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
TXPA07773363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant