Individual
TEENA SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2017
(347) 963-2335
Mailing address
293 AUBURN HLS, SUNNYVALE, TX 75182-0044
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
56038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56038
PHARMACIST LICENSE
TX
Enumeration date
07/30/2020
Last updated
07/30/2020
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