IndividualActive
Amanda Mirise, DPT
NPI 1497566624 · Pediatric Physical Therapist · Tyler, TX
Provider details
- NPI number
- 1497566624
- Entity type
- Individual
- Primary specialty
- Pediatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1401088 (TX)
Mailing address
100 E Ferguson St
Tyler, TX 75702-5759
Registry dates
- Enumerated
- 2025-01-16
- Last updated
- 2025-01-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.