Provider Demographics
NPI:1053684019
Name:LOVELLE, DOROTHEA
Entity Type:Individual
Prefix:DR
First Name:DOROTHEA
Middle Name:
Last Name:LOVELLE
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 1:1701 DALLAS PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4580
Mailing Address - Country:US
Mailing Address - Phone:972-246-2202
Mailing Address - Fax:972-246-2223
Practice Address - Street 1:1701 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4580
Practice Address - Country:US
Practice Address - Phone:972-246-2202
Practice Address - Fax:972-246-2223
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist