Healthcare Provider Details

I. General information

NPI: 1528741923
Provider Name (Legal Business Name): AMBER GAFFORD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6611 N BELT LINE RD STE 100
IRVING TX
75063-6001
US

IV. Provider business mailing address

6611 N BELT LINE RD STE 100
IRVING TX
75063-6001
US

V. Phone/Fax

Practice location:
  • Phone: 972-536-7355
  • Fax:
Mailing address:
  • Phone: 972-536-7355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number72847
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: