Provider Demographics
NPI:1174832448
Name:WHITTIKER, DENITA (PHARM D)
Entity Type:Individual
Prefix:
First Name:DENITA
Middle Name:
Last Name:WHITTIKER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N BEECH ST
Mailing Address - Street 2:APT 102
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-2759
Mailing Address - Country:US
Mailing Address - Phone:832-353-7018
Mailing Address - Fax:
Practice Address - Street 1:203 W FERGUSON RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-4809
Practice Address - Country:US
Practice Address - Phone:903-572-0486
Practice Address - Fax:903-572-0380
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist