Provider Demographics
NPI:1245568120
Name:HUDDLESTON, ADAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:HUDDLESTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-3763
Mailing Address - Country:US
Mailing Address - Phone:806-371-8116
Mailing Address - Fax:806-371-8730
Practice Address - Street 1:801 N FILLMORE ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-3763
Practice Address - Country:US
Practice Address - Phone:806-371-8116
Practice Address - Fax:806-371-8730
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist