Provider Demographics
NPI:1093378846
Name:TURNER, KAREN LEA
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEA
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 COUNTY ROAD 198
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:TX
Mailing Address - Zip Code:75643-3705
Mailing Address - Country:US
Mailing Address - Phone:903-754-3043
Mailing Address - Fax:
Practice Address - Street 1:917 E AUSTIN ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2845
Practice Address - Country:US
Practice Address - Phone:936-564-7373
Practice Address - Fax:936-564-9338
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1679642250OtherM&S PHARMACY