Provider Demographics
NPI:1184028813
Name:ZAREK, JORDAN DANIELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:DANIELLE
Last Name:ZAREK
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 1:3301 DENTON HWY
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-3200
Mailing Address - Country:US
Mailing Address - Phone:817-222-9247
Mailing Address - Fax:
Practice Address - Street 1:3301 DENTON HWY
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-3200
Practice Address - Country:US
Practice Address - Phone:817-222-9247
Practice Address - Fax:847-697-6769
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051297869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist