Provider Demographics
NPI:1477688851
Name:ECHEVERRIA, AMANDA (DDS, MS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ECHEVERRIA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8719 OAK KOLBE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-1469
Mailing Address - Country:US
Mailing Address - Phone:713-398-2663
Mailing Address - Fax:281-809-7044
Practice Address - Street 1:4400 POST OAK PKWY STE 2585
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3459
Practice Address - Country:US
Practice Address - Phone:713-961-0088
Practice Address - Fax:713-961-7594
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160790502Medicaid