Provider Demographics
NPI:1326648791
Name:SCHLOTTERBACK, ANITA ISBELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:ISBELL
Last Name:SCHLOTTERBACK
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 1:406 TONKAWA TRL W
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1601
Mailing Address - Country:US
Mailing Address - Phone:512-762-9406
Mailing Address - Fax:
Practice Address - Street 1:201 WALTON WAY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7016
Practice Address - Country:US
Practice Address - Phone:512-528-8794
Practice Address - Fax:512-528-8612
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist