Individual provider Active NPI

Amanda J Trump, M.D.

  • Dermatology Physician
  • Jbsa Lackland, TX
National Provider Identifier
1154760346
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
V6621 Issued in TX
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-6255
Fax
(210) 292-7934
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X V6621 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (831) 238-6699

Other practice location 1

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 956-1235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009000608 TX Practitioner - Dermatology 1355603887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

11503 NW Military Hwy
Suite 321
San Antonio, TX 78231-1896
Phone (726) 213-3494

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Whasc CurrentSince Jun 29, 2025 Accepting new patients
Epiphany Dermatology PA Dermatology CurrentSince Oct 1, 2025 Accepting new patients

Locations

7300 Ranch Road 2222
Bldg 1
Austin, TX 78730

1100 Wilford Hall Loop
Bldg 4554
San Antonio, TX 78236
Phone (210) 292-6225

11503 NW Military Hwy
Ste 321
San Antonio, TX 78231
Phone (210) 492-1677

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1154760346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "831-238-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6255",
            "fax_number": "210-292-7934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-956-1235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUMP",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "V6621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.