Provider Demographics
NPI:1093162307
Name:KNEIFEL, CHANTAL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHANTAL
Middle Name:
Last Name:KNEIFEL
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 1:11508 STAKED PLAINS DR
Mailing Address - Street 2:UNIT 1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4480
Mailing Address - Country:US
Mailing Address - Phone:210-416-3129
Mailing Address - Fax:
Practice Address - Street 1:300 W VETERANS BLVD
Practice Address - Street 2:119 PHARMACY DEPARTMENT
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-5566
Practice Address - Country:US
Practice Address - Phone:432-268-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist