Provider Demographics
NPI:1730697186
Name:ADAMS, AMY (LAC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 JOYCE WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-1730
Mailing Address - Country:US
Mailing Address - Phone:214-808-4776
Mailing Address - Fax:
Practice Address - Street 1:10260 N CENTRAL EXPY STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3426
Practice Address - Country:US
Practice Address - Phone:469-729-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty