Provider Demographics
NPI:1588215776
Name:TUSING, AMANDA KLONTZ
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KLONTZ
Last Name:TUSING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34506 KRISTINE
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:TX
Mailing Address - Zip Code:77362-3416
Mailing Address - Country:US
Mailing Address - Phone:409-502-1148
Mailing Address - Fax:
Practice Address - Street 1:3831 E LEAGUE CITY PKWY STE A
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7155
Practice Address - Country:US
Practice Address - Phone:281-581-7008
Practice Address - Fax:281-957-9476
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143161363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics