Provider Demographics
NPI:1083965412
Name:ESSARY, STEPHANIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:ESSARY
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 1:1300 PLACID CIR
Mailing Address - Street 2:APT. 6302
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-4501
Mailing Address - Country:US
Mailing Address - Phone:512-913-1665
Mailing Address - Fax:
Practice Address - Street 1:801 N INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76705-2874
Practice Address - Country:US
Practice Address - Phone:254-799-0219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist