Active NPI
Amanda Leanne Logan
- Surgical Technologist
- Arlington, TX
National Provider Identifier
1740440486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 633320
- Practice address
- 811 Interstate 20 W
#114
Arlington, TX 76017-5870 - Phone
- (817) 784-8268
- Fax
- (817) 468-9165
- NPI assigned
- Jun 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 633320 | KS | Primary |
Addresses
Primary practice location
811 Interstate 20 W
#114
Arlington, TX 76017-5870
Mailing address
PO Box 120549
Arlington, TX 76012-0549
Phone (817) 303-4521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 633320 | KS | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1740440486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 120549",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760120549",
"telephone_number": "817-303-4521",
"fax_number": "817-459-2856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 INTERSTATE 20 W",
"address_2": "#114",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760175870",
"telephone_number": "817-784-8268",
"fax_number": "817-468-9165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "AMANDA",
"middle_name": "LEANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-16",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "KS",
"license": "633320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.