Sustaita, Amy D

Sustaita, Amy D is an individual health care provider with primary practice located at 815 S Washington Ave Ste 100 , Marshall TX 75670-5316. 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. Sustaita, Amy D can be contacted via phone (903) 927-6800.

Contact Information

Primary practice address
815 S Washington Ave Ste 100 Marshall TX 75670-5316
Phone: (903) 927-6800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA07123 Texas

Profile Details

NPI number 1003113770
LBN Legal business name Sustaita, Amy D
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2011
Last updated Apr 16th, 2021 - about 5 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 1003113770 NPPES
Texas MEDICAID 420661701

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