Provider Demographics
NPI:1306857115
Name:EDWARDS, KRYSTAL LIEBZEIT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:LIEBZEIT
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:BLDG 7, R#119A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-372-5300
Mailing Address - Fax:214-372-5020
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:BLDG 7, R#119A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-372-5300
Practice Address - Fax:214-372-5020
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX411281835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy