Provider Demographics
NPI:1619564101
Name:REEDER, AMANDA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:REEDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13458 OAK HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2933
Mailing Address - Country:US
Mailing Address - Phone:314-609-0775
Mailing Address - Fax:
Practice Address - Street 1:1325 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3808
Practice Address - Country:US
Practice Address - Phone:281-444-4582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist