Provider Demographics
NPI:1508461922
Name:SAM, TAMEYA GERALDINE (RPH)
Entity Type:Individual
Prefix:DR
First Name:TAMEYA
Middle Name:GERALDINE
Last Name:SAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3595 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4615
Mailing Address - Country:US
Mailing Address - Phone:409-835-1788
Mailing Address - Fax:
Practice Address - Street 1:3595 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4615
Practice Address - Country:US
Practice Address - Phone:409-835-1788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist