Provider Demographics
NPI:1346327509
Name:LOWE, DEANNA DEAN (RPH)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:DEAN
Last Name:LOWE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BLUE BONNET DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2108
Mailing Address - Country:US
Mailing Address - Phone:817-295-3651
Mailing Address - Fax:817-483-2236
Practice Address - Street 1:301 W KENNEDALE PKWY
Practice Address - Street 2:
Practice Address - City:KENNEDALE
Practice Address - State:TX
Practice Address - Zip Code:76060-2421
Practice Address - Country:US
Practice Address - Phone:817-478-8225
Practice Address - Fax:817-483-2236
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist