Provider Demographics
NPI:1003218363
Name:DARGIN, ANDREE (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREE
Middle Name:
Last Name:DARGIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ANDREE
Other - Middle Name:
Other - Last Name:DARGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10223 BROADWAY ST
Mailing Address - Street 2:SUITE P318
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:832-785-7132
Mailing Address - Fax:
Practice Address - Street 1:10223 BROADWAY ST
Practice Address - Street 2:SUITE P318
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7880
Practice Address - Country:US
Practice Address - Phone:832-785-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist