Healthcare Provider Details

I. General information

NPI: 1588787295
Provider Name (Legal Business Name): TAMARA LYNNE REITER PHARM.D., BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N BECKLEY AVE DEPARTMENT OF PHARMACY
DALLAS TX
75203-1201
US

IV. Provider business mailing address

812 OLDE TOWNE DR
IRVING TX
75061-9120
US

V. Phone/Fax

Practice location:
  • Phone: 214-947-2412
  • Fax: 214-947-2402
Mailing address:
  • Phone: 214-441-3474
  • Fax: 214-947-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number40023
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: