Provider Demographics
NPI:1881297463
Name:GARCIA, AMANDA KAY (NP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KAY
Other - Last Name:ECCLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3827 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3339
Mailing Address - Country:US
Mailing Address - Phone:303-500-1518
Mailing Address - Fax:720-598-0440
Practice Address - Street 1:2550 GRAY FALLS DR STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6687
Practice Address - Country:US
Practice Address - Phone:713-422-2920
Practice Address - Fax:720-598-0440
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019853363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1019853OtherTEXAS BON
TX1019853OtherTX NURSING BOARD