Provider Demographics
NPI:1306214838
Name:JOSEPH, STEPHANIE ANTONIA (PHARMD RPH)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANTONIA
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 LAUREN TRL
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-8835
Mailing Address - Country:US
Mailing Address - Phone:281-412-5021
Mailing Address - Fax:
Practice Address - Street 1:1213 3RD ST NW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-4116
Practice Address - Country:US
Practice Address - Phone:406-761-0214
Practice Address - Fax:406-761-0911
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist