Provider Demographics
NPI:1982057618
Name:NGO, AMY (ATC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 GREAT HILLS TRL
Mailing Address - Street 2:APT 833
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7187
Mailing Address - Country:US
Mailing Address - Phone:402-450-9286
Mailing Address - Fax:
Practice Address - Street 1:8403 MESA DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8117
Practice Address - Country:US
Practice Address - Phone:402-450-9286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT5991A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer