Provider Demographics
NPI:1912902156
Name:HUNT, AMANDA LOUISE (OD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LOUISE
Last Name:HUNT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18850 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4288
Mailing Address - Country:US
Mailing Address - Phone:713-275-2457
Mailing Address - Fax:713-275-2466
Practice Address - Street 1:429 W SOUTHLINE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-5000
Practice Address - Country:US
Practice Address - Phone:281-592-4343
Practice Address - Fax:281-592-8602
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6590T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170314201Medicaid
TXV01343Medicare UPIN
TX8C2309Medicare ID - Type Unspecified