Provider Demographics
NPI:1326202128
Name:MONTANARO, HALEY PHELPS (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:PHELPS
Last Name:MONTANARO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:PAIGE
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:201 E CENTRAL TEXAS EXPY BLDG 3
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2747
Mailing Address - Country:US
Mailing Address - Phone:254-953-5881
Mailing Address - Fax:254-953-5881
Practice Address - Street 1:201 E CENTRAL TEXAS EXPY BLDG 3
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2747
Practice Address - Country:US
Practice Address - Phone:254-953-5881
Practice Address - Fax:254-953-5881
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45954183500000X
GARPH022784183500000X
MSE-09919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist