Provider Demographics
NPI:1588787295
Name:REITER, TAMARA LYNNE (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LYNNE
Last Name:REITER
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 OLDE TOWNE DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-9120
Mailing Address - Country:US
Mailing Address - Phone:214-441-3474
Mailing Address - Fax:214-947-2402
Practice Address - Street 1:1441 N BECKLEY AVE
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-947-2412
Practice Address - Fax:214-947-2402
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX400231835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy