Provider Demographics
NPI:1568621159
Name:CARPENTER, AMANDA CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:CHRISTINE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:18707 HARDY OAK BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4791
Mailing Address - Country:US
Mailing Address - Phone:210-657-0220
Mailing Address - Fax:210-402-2868
Practice Address - Street 1:18707 HARDY OAK BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4791
Practice Address - Country:US
Practice Address - Phone:210-657-0220
Practice Address - Fax:210-402-2868
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8721208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics