Provider Demographics
NPI:1043547136
Name:DULANEY, FAITH PORTER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:PORTER
Last Name:DULANEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76241-0238
Mailing Address - Country:US
Mailing Address - Phone:940-612-1613
Mailing Address - Fax:
Practice Address - Street 1:319 COUNTY ROAD 224
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-0449
Practice Address - Country:US
Practice Address - Phone:940-612-1613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18619183500000X
OK7753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist