Individual provider · Type 1 NPI

Amanda Isabel Licea, PA-C

Medical Physician Assistant · Austin, TX

NPI number 1609110683 Active

Practice location

608 Radam Ln
Austin, TX 78745-1172

Call (512) 443-5988 Map

Fax (512) 443-5055

Mailing address

8240 N Mopac Expy Ste 100
Austin, TX 78759-8869

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA08169 (TX)

Medical Physician Assistant: Definition to come...

20 other providers at this address

Other medical physician assistant providers in Austin

See all in Austin →

About NPI 1609110683

Amanda Isabel Licea, PA-C's National Provider Identifier is 1609110683, issued on Nov 15, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Austin, TX. The record was last updated on Sep 22, 2021.