Provider Demographics
NPI:1235328840
Name:CLAY, ANDREA LYNETTE (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNETTE
Last Name:CLAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4142 PRESIDENTS DR S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-6764
Mailing Address - Country:US
Mailing Address - Phone:713-298-5486
Mailing Address - Fax:
Practice Address - Street 1:4142 PRESIDENTS DR S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-6764
Practice Address - Country:US
Practice Address - Phone:713-298-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist