Infinity Invictus, PLLC.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

N8596 Issued in TX

Legal business name

INFINITY INVICTUS, PLLC.

Practice address

800 8TH Ave
Suite 326
Ft Worth, TX 76104-2601

Phone

(972) 795-3529

NPI assigned

Feb 29, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Amanda Jo Wolthoff, M.D.

Title

Physician, Owner

Phone

(817) 846-8502

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1417317769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 JACKSON CREEK DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435001",
            "telephone_number": "817-846-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE",
            "address_2": "SUITE 326",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761042601",
            "telephone_number": "972-795-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY INVICTUS, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "WOLTHOFF",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "817-846-8502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N8596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992016869",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.