Provider Demographics
NPI:1407077944
Name:SPRABARY, STACI DENISE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:STACI
Middle Name:DENISE
Last Name:SPRABARY
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 SAGEBRUSH DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-8434
Mailing Address - Country:US
Mailing Address - Phone:940-390-5146
Mailing Address - Fax:
Practice Address - Street 1:1800 W. CHESTNUT
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76203-5160
Practice Address - Country:US
Practice Address - Phone:940-565-2798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112171183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112171OtherTX STATE BOARD OF PHARM
TX130101477736511OtherPTCB