Provider Demographics
NPI:1871262329
Name:HOLLIDAY, ANDREA THERESA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:THERESA
Last Name:HOLLIDAY
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 1:1700 CEDAR SPRINGS RD APT 2012
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-1224
Mailing Address - Country:US
Mailing Address - Phone:901-289-3972
Mailing Address - Fax:
Practice Address - Street 1:1700 CEDAR SPRINGS RD APT 2012
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-1224
Practice Address - Country:US
Practice Address - Phone:901-289-3972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist