Provider Demographics
NPI:1598875700
Name:SPAULDING, PAMELA DIANE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DIANE
Last Name:SPAULDING
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 1:7710 SILVER SPUR TRL
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4117
Mailing Address - Country:US
Mailing Address - Phone:830-755-2423
Mailing Address - Fax:
Practice Address - Street 1:1223 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2813
Practice Address - Country:US
Practice Address - Phone:830-249-9565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36819183500000X
IL051 037870183500000X
IN26017438A183500000X
TX47774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist