Amanda Rae Wolters

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

51819 Issued in TX

Practice address

1712 Spring Green Blvd
Katy, TX 77494-6910

Phone

(281) 769-4361

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kroger Texas LP

  • Community/Retail Pharmacy
  • Katy, TX
  • NPI 1235528605
  NPD (past)
• Kroger Texas LP

  • Community/Retail Pharmacy
  • Fort Worth, TX
  • NPI 1407747439
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1336748276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 SPRING GREEN BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946910",
            "telephone_number": "281-769-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 SPRING GREEN BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946910",
            "telephone_number": "281-769-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERS",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "51819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wishing Well Children'S Clinic, PLLC
• Kelly Jean Wisner, PT
• Jessica Withaar
• Within These Walls Professional Counseling Center PLLC
• Judith Wogu
• Dawn Womack, LCSW
• Milton Womack, ED.D.
• Women Specialists of Katy, P.a.
• Women Specialists of Katy, P.a.
• Wonace LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Katy, TX
• Providers in Katy, TX by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.