Provider Demographics
NPI:1083186936
Name:PINSON, AMANDA NICOLE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NICOLE
Last Name:PINSON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:NICOLE
Other - Last Name:QUINTAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:9319 PINECROFT DR STE 110
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3485
Mailing Address - Country:US
Mailing Address - Phone:281-298-1129
Mailing Address - Fax:281-298-1168
Practice Address - Street 1:9319 PINECROFT DR STE 110
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3485
Practice Address - Country:US
Practice Address - Phone:281-298-1129
Practice Address - Fax:281-298-1168
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211136183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician