Provider Demographics
NPI:1861755506
Name:HUSSEY, AMY (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 HARRIS PKWY STE 1240
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4248
Mailing Address - Country:US
Mailing Address - Phone:817-789-6333
Mailing Address - Fax:
Practice Address - Street 1:6100 HARRIS PKWY STE 1240
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4248
Practice Address - Country:US
Practice Address - Phone:817-789-6333
Practice Address - Fax:817-433-5177
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR9989207Q00000X
NJ25MB09550200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine