AMANDA ISABEL LICEA

AUSTIN, TX
NPI1609110683
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: TX  PA08169)
Enumeration Date2012-11-15
Last Update Date2021-09-22
Business Address
AMANDA ISABEL LICEA PA-C
608 RADAM LN
AUSTIN, TX 78745-1172
Phone number: 512-443-5988
Mailing Address
AMANDA ISABEL LICEA PA-C
8240 N MOPAC EXPY STE 100
AUSTIN, TX 78759-8869
Phone number: 512-687-1950
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