Provider Demographics
NPI:1154658052
Name:CHARGOIS, STACY (PHARMD)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:CHARGOIS
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 1:5775 FM 423
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8956
Mailing Address - Country:US
Mailing Address - Phone:214-469-1486
Mailing Address - Fax:
Practice Address - Street 1:5775 FM 423
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8956
Practice Address - Country:US
Practice Address - Phone:214-469-1486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist