Provider Demographics
NPI:1952864738
Name:AMANDOSSOVA, GAUKHAR ERZHANOVNA
Entity type:Individual
Prefix:
First Name:GAUKHAR
Middle Name:ERZHANOVNA
Last Name:AMANDOSSOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8103
Mailing Address - Country:US
Mailing Address - Phone:806-743-6744
Mailing Address - Fax:
Practice Address - Street 1:TCH WOODLANDS-OUTPATIENT SERVICES
Practice Address - Street 2:17580 INTERSTATE 45
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:832-822-4897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV13922084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry