Provider Demographics
NPI:1326312406
Name:POGUE-OLIVARES, DAWN LYNN (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LYNN
Last Name:POGUE-OLIVARES
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26013 S GLENROSE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-5336
Mailing Address - Country:US
Mailing Address - Phone:210-508-7448
Mailing Address - Fax:830-714-4485
Practice Address - Street 1:26013 S GLENROSE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-5336
Practice Address - Country:US
Practice Address - Phone:210-508-7448
Practice Address - Fax:830-714-4485
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist