Organization Active NPI

Amy K. Mettman, M.D., P.a.

  • Otolaryngology Physician
  • Southlake, TX
National Provider Identifier
1386939262
Registry record updated Jun 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
AMY K. METTMAN, M.D., P.A.
Practice address
660 W Southlake Blvd Ste 100
Southlake, TX 76092-6070
Phone
(817) 416-9731
NPI assigned
Jun 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2011

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

Authorized official

Name
Dr. Amy K Mettman, M.D.
Title
President
Phone
(513) 300-0513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

660 W Southlake Blvd Ste 100
Southlake, TX 76092-6070

Mailing address

660 W Southlake Blvd Ste 100
Southlake, TX 76092-6070

National Provider Directory

National Provider Directory

Locations

660 W Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 416-9731

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308355200000",
    "number": "1386939262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 W SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 W SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926070",
            "telephone_number": "817-416-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY K. METTMAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-18",
        "last_updated": "2011-06-18",
        "status": "A",
        "authorized_official_last_name": "METTMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-300-0513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.