Lightsey, Amanda Jean

Lightsey, Amanda Jean is an sole proprietor health care provider with primary practice located at 2651 Boonville Rd Ste 115 , Bryan TX 77808-2334. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Lightsey, Amanda Jean can be contacted via phone (979) 446-0422.

Contact Information

Primary practice address
2651 Boonville Rd Ste 115 Bryan TX 77808-2334
Phone: (979) 446-0422
Fax: (979) 446-0433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1145365 Texas

Profile Details

NPI number 1174586432
LBN Legal business name Lightsey, Amanda Jean
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 8th, 2006
Last updated Jun 28th, 2016 - about 9 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 1174586432 NPPES
Texas Other 8T2272 BLUE SHIELD
Texas MEDICAID 1651572-02 BLUE SHIELD

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