Provider Demographics
NPI:1174819965
Name:WEYRENS, BRENDA JENSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JENSON
Last Name:WEYRENS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 W FM 544
Mailing Address - Street 2:T-2550
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-9408
Mailing Address - Country:US
Mailing Address - Phone:972-769-3944
Mailing Address - Fax:972-769-3954
Practice Address - Street 1:3440 W FM 544
Practice Address - Street 2:T-2550
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-9408
Practice Address - Country:US
Practice Address - Phone:972-769-3944
Practice Address - Fax:972-769-3954
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist