Provider Demographics
NPI:1508874520
Name:HOELSCHER, AMANDA K (OD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:K
Last Name:HOELSCHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:K
Other - Last Name:KUBON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:11442 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6602
Mailing Address - Country:US
Mailing Address - Phone:214-754-0000
Mailing Address - Fax:214-379-1849
Practice Address - Street 1:2801 LEMMON AVE STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2399
Practice Address - Country:US
Practice Address - Phone:214-754-0000
Practice Address - Fax:214-379-1849
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04827TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045250002Medicaid
TXP00608703Medicare PIN
TX045250002Medicaid
TX8K7392Medicare PIN
U49853Medicare UPIN