Provider Demographics
NPI:1942971338
Name:AMAYA, ANGEL (APRN MSN FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:AMAYA
Suffix:
Gender:M
Credentials:APRN MSN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 VICTORIA LN STE 2
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3227
Mailing Address - Country:US
Mailing Address - Phone:956-365-4400
Mailing Address - Fax:956-365-4111
Practice Address - Street 1:4211 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6907
Practice Address - Country:US
Practice Address - Phone:956-365-4400
Practice Address - Fax:956-365-4111
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1053608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily