Provider Demographics
NPI:1407454820
Name:BENTLEY, DONNA R (RPH)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:R
Last Name:BENTLEY
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 1:2605 COUNTY ROAD 197
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-1014
Mailing Address - Country:US
Mailing Address - Phone:281-610-8548
Mailing Address - Fax:
Practice Address - Street 1:3100 S HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-1413
Practice Address - Country:US
Practice Address - Phone:281-388-3403
Practice Address - Fax:281-388-3406
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX391821835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist