Provider Demographics
NPI:1093319469
Name:SMITH, ABIGAIL LOU (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LOU
Last Name:SMITH
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 1:3312 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7404
Mailing Address - Country:US
Mailing Address - Phone:469-304-3124
Mailing Address - Fax:972-596-4705
Practice Address - Street 1:3312 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7404
Practice Address - Country:US
Practice Address - Phone:469-304-3124
Practice Address - Fax:972-596-4705
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist