| Amanda Sisul | |
|
821 W 11th St Austin TX 78701-2009 | |
| (512) 952-2644 | |
| (512) 668-7885 |
| Full Name | Amanda Sisul |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 821 W 11th St, Austin, Texas |
| Authorized Official Name and Position | Amanda Sisul (OWNER) |
| Authorized Official Contact | 5129522644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Sisul 13359 N Highway 183 Ste 406-533 Austin TX 78750-7153 Ph: (512) 952-2644 | Amanda Sisul 821 W 11th St Austin TX 78701-2009 Ph: (512) 952-2644 |
| NPI Number | 1164203402 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 7517314230 |
|---|---|
| Medicare Enrollment ID | O20231116002754 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164203402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Amanda Brittany Sisul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386137461 PECOS PAC ID: 8426405143 Enrollment ID: I20231116002891 |
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