Lark, Amanda Wilder

Lark, Amanda Wilder is an individual health care provider with primary practice located at 4471 Long Prairie Rd # 100 , Flower Mound TX 75028. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Lark, Amanda Wilder can be contacted via phone (972) 362-0956.

Contact Information

Primary practice address
4471 Long Prairie Rd # 100 Flower Mound TX 75028
Phone: (972) 362-0956
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA03432 Texas

Profile Details

NPI number 1841478302
LBN Legal business name Lark, Amanda Wilder
Credentials MPAS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2008
Last updated Oct 3rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841478302 NPPES
Texas MEDICAID 285113102
Texas MEDICAID 285113101

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