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General NPI Number Information
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NPI Number | 1992453658
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Entity Type | Individual
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Provider Name | AMANDA HAYNES PHARM D
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Gender | Female
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Dates
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Enumeration Date | 03/12/2022
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Last Update Date | 03/12/2022
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Provider Practice Location Address
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Address Line | 2306 RANCH ROAD 620 S
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City | LAKEWAY
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State | TX
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Zip | 78734-6269
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Country | US
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Telephone | 512-263-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 CRAZYHORSE PASS
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City | AUSTIN
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State | TX
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Zip | 78734-2805
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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 | 2007028060
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63988
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License Number State | TX
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