Provider Demographics
NPI:1467819474
Name:REGAS, AMY R (AGNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:REGAS
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31185 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-5021
Mailing Address - Country:US
Mailing Address - Phone:512-699-3509
Mailing Address - Fax:
Practice Address - Street 1:21212 NORTHWEST FREEWAY
Practice Address - Street 2:535
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5888
Practice Address - Country:US
Practice Address - Phone:281-912-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128793363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner