IndividualActive
Amanda Wickson, PA-C
NPI 1710177464 · Physician Assistant · Keller, TX
Provider details
- NPI number
- 1710177464
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA02797 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
808 Keller Pkwy
Keller, TX 76248-2405
Phone: (817) 431-2573
Fax: (817) 379-6881
Approximate (ZIP-level) locationGet directions
Mailing address
808 Keller Pkwy
Keller, TX 76248-2405
Registry dates
- Enumerated
- 2007-07-30
- Last updated
- 2010-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.