Provider Demographics
NPI:1245402700
Name:CARDENAS, AMY (STA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:STA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 EATON LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6001 W WILLIAM CANNON DR
Practice Address - Street 2:BLDG I, SUITE 304
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1968
Practice Address - Country:US
Practice Address - Phone:512-394-0652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX324162355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant