Provider Demographics
NPI:1043768930
Name:TRAMMELL, PAULA (RPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:TRAMMELL
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 1:6724 MURPHY ST
Mailing Address - Street 2:
Mailing Address - City:MURCHISON
Mailing Address - State:TX
Mailing Address - Zip Code:75778-3348
Mailing Address - Country:US
Mailing Address - Phone:903-288-2723
Mailing Address - Fax:
Practice Address - Street 1:829 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-3048
Practice Address - Country:US
Practice Address - Phone:903-874-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist