Provider Demographics
NPI:1306619895
Name:AUBREY, T'ANDRA
Entity type:Individual
Prefix:
First Name:T'ANDRA
Middle Name:
Last Name:AUBREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 S FRY RD STE 285
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2258
Mailing Address - Country:US
Mailing Address - Phone:346-594-1049
Mailing Address - Fax:346-594-1059
Practice Address - Street 1:707 S FRY RD STE 285
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2258
Practice Address - Country:US
Practice Address - Phone:346-594-1049
Practice Address - Fax:346-594-1059
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy