Provider Demographics
NPI:1346528312
Name:GROOMS, DENEISE NICOLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DENEISE
Middle Name:NICOLE
Last Name:GROOMS
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 1:32858 FM 2978 RD
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-6073
Mailing Address - Country:US
Mailing Address - Phone:281-296-3050
Mailing Address - Fax:281-296-3060
Practice Address - Street 1:32858 FM 2978 RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-6073
Practice Address - Country:US
Practice Address - Phone:281-296-3050
Practice Address - Fax:281-296-3060
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist