Provider Demographics
NPI:1073136123
Name:MCLEAN, BROOKE M (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:M
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 S COULTER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1761
Mailing Address - Country:US
Mailing Address - Phone:806-350-7451
Mailing Address - Fax:806-350-7454
Practice Address - Street 1:1215 S COULTER ST STE 101
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1761
Practice Address - Country:US
Practice Address - Phone:806-350-7451
Practice Address - Fax:806-350-7454
Is Sole Proprietor?:No
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist