Provider Demographics
NPI:1033447941
Name:BREWER, TAMMY RENEE
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:BREWER
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 1:5206 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-4302
Mailing Address - Country:US
Mailing Address - Phone:806-792-1377
Mailing Address - Fax:806-792-2816
Practice Address - Street 1:5206 4TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-4302
Practice Address - Country:US
Practice Address - Phone:806-792-1377
Practice Address - Fax:806-792-2816
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist