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General NPI Number Information
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NPI Number | 1497005490
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Entity Type | Individual
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Provider Name | NANA AMA SAM PHARM D
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Gender | Female
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 3033 S 14TH ST
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City | ABILENE
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State | TX
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Zip | 79605-4551
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Country | US
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Telephone | 325-795-1440
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Fax | 325-795-1374
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Provider Business Mailing Address
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Address Line | 11900 WICKCHESTER LN APT 1221
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City | HOUSTON
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State | TX
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Zip | 77043-4551
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Country | US
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Telephone |
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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 | 52237
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License Number State | TX
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