Provider Demographics
NPI:1396886644
Name:MCCARTY, AMANDA (CPM, LM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 S TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-2656
Mailing Address - Country:US
Mailing Address - Phone:806-584-6214
Mailing Address - Fax:806-322-1580
Practice Address - Street 1:2010 S TAYLOR ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-2656
Practice Address - Country:US
Practice Address - Phone:806-584-6214
Practice Address - Fax:806-322-1580
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04016176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife