Provider Demographics
NPI:1851383632
Name:AMENEDO, VERONICA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ANN
Last Name:AMENEDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:VERONICA
Other - Middle Name:ANN
Other - Last Name:AMENEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:929 GESSNER RD STE 2450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2593
Mailing Address - Country:US
Mailing Address - Phone:713-464-9939
Mailing Address - Fax:713-464-9942
Practice Address - Street 1:929 GESSNER RD STE 2450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2593
Practice Address - Country:US
Practice Address - Phone:713-464-9939
Practice Address - Fax:713-464-9942
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00762363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K9776Medicare PIN
TXR56194Medicare UPIN