Provider Demographics
NPI:1518646827
Name:AMAIDAS, ROSHANI (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSHANI
Middle Name:
Last Name:AMAIDAS
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 1:3424 BEGONIA LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3569
Mailing Address - Country:US
Mailing Address - Phone:214-683-7682
Mailing Address - Fax:
Practice Address - Street 1:190 E STACY RD STE 210
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8738
Practice Address - Country:US
Practice Address - Phone:972-525-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor