Provider Demographics
NPI:1073890430
Name:STEVENS, JANICE GAIL (RPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:GAIL
Last Name:STEVENS
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 1:1118 S TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-8508
Mailing Address - Country:US
Mailing Address - Phone:903-267-6072
Mailing Address - Fax:
Practice Address - Street 1:5016 S US HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4584
Practice Address - Country:US
Practice Address - Phone:903-416-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313681835P0018X
KS1-101931835P0018X
IN26016254A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist