Provider Demographics
NPI:1346468691
Name:MORINE, RODALYN (RPH)
Entity Type:Individual
Prefix:
First Name:RODALYN
Middle Name:
Last Name:MORINE
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 1:1352 GREEN HILLS CT
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-2842
Mailing Address - Country:US
Mailing Address - Phone:972-572-4244
Mailing Address - Fax:972-572-4244
Practice Address - Street 1:6303 FOREST PARK RD
Practice Address - Street 2:SUITE 255-A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5450
Practice Address - Country:US
Practice Address - Phone:214-357-8889
Practice Address - Fax:214-357-8370
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist