Provider Demographics
NPI:1104003714
Name:SIBR, JESSACA THERESE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSACA
Middle Name:THERESE
Last Name:SIBR
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 1:6350 DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-4756
Mailing Address - Country:US
Mailing Address - Phone:817-498-6500
Mailing Address - Fax:817-498-8739
Practice Address - Street 1:6350 DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-4756
Practice Address - Country:US
Practice Address - Phone:817-498-6500
Practice Address - Fax:817-498-8739
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist