Provider Demographics
NPI:1902247711
Name:GARNER, AMANDA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MICHELLE
Last Name:GARNER
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 1:1101 C-BAR RANCH TRL
Mailing Address - Street 2:TARGET PHARMACY T2342
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7595
Mailing Address - Country:US
Mailing Address - Phone:512-456-2934
Mailing Address - Fax:512-456-2944
Practice Address - Street 1:1101 C-BAR RANCH TRL
Practice Address - Street 2:TARGET PHARMACY T2342
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7595
Practice Address - Country:US
Practice Address - Phone:512-456-2934
Practice Address - Fax:512-456-2944
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist