Basic Information
| Provider Information | |||||||||
| NPI: | 1750730461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDRADE | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | I. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 MONTROSE BLVD APT 910 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770064330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152766158 | ||||||||
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| Practice Location | |||||||||
| Address1: | 925 N SHEPHERD DR DEPT OF | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770086526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257131 | ||||||||
| FaxNumber: | 7133831479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2016 | ||||||||
| LastUpdateDate: | 10/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | S6784 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.