Provider Demographics
NPI:1013246362
Name:GOLDEN, AMANDA (DC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:GOLDEN
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 1:19780 ATASCOCITA SHORES DR
Mailing Address - Street 2:APT 311
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2384
Mailing Address - Country:US
Mailing Address - Phone:614-795-7295
Mailing Address - Fax:
Practice Address - Street 1:13817 HIGHWAY 59
Practice Address - Street 2:SUITE C
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-4698
Practice Address - Country:US
Practice Address - Phone:832-303-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2011-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11292111N00000X, 111NN1001X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor