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General NPI Number Information
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NPI Number | 1033879929
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Entity Type | Individual
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Provider Name | AMANDA TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 3050 W GRAND PKWY S
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City | KATY
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State | TX
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Zip | 77494-1502
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Country | US
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Telephone | 281-392-3788
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 DUNVALE RD APT 11306
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City | HOUSTON
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State | TX
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Zip | 77063-4497
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Country | US
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Telephone | 832-420-5264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 69605
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License Number State | TX
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