Provider Demographics
NPI:1194939850
Name:RAY DRODDY, AMBER L (MD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:RAY DRODDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9922
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-6922
Mailing Address - Country:US
Mailing Address - Phone:281-419-5818
Mailing Address - Fax:281-465-4596
Practice Address - Street 1:1111 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 250
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3476
Practice Address - Country:US
Practice Address - Phone:281-419-5818
Practice Address - Fax:281-465-4596
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J21AOtherGROUP MEDICARE NUMBER
TX00J21AOtherGROUP MEDICARE NUMBER
TXTXB123457Medicare UPIN
TXTXB123464Medicare PIN