Provider Demographics
NPI:1659901296
Name:AMAYREH, ALYSHA (DC)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:AMAYREH
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 1:109 E OVILLA RD
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-2416
Mailing Address - Country:US
Mailing Address - Phone:972-617-7700
Mailing Address - Fax:
Practice Address - Street 1:109 E OVILLA RD
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2416
Practice Address - Country:US
Practice Address - Phone:972-617-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013512111N00000X
TX15354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor