Provider Demographics
NPI:1669601092
Name:NIETFELD, LAURA AMANDA (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:AMANDA
Last Name:NIETFELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:AMANDA
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11130 CHRISTUS HILLS
Mailing Address - Street 2:MEDICAL PLAZA 3, 3RD FLOOR
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3585
Mailing Address - Country:US
Mailing Address - Phone:210-703-9001
Mailing Address - Fax:210-703-9155
Practice Address - Street 1:11130 CHRISTUS HILLS
Practice Address - Street 2:MEDICAL PLAZA 3, 3RD FLOOR
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3585
Practice Address - Country:US
Practice Address - Phone:210-703-9001
Practice Address - Fax:210-703-9155
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine