Provider Demographics
NPI:1407856107
Name:MAREK, NINA (RPH)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:
Last Name:MAREK
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 1:901 COUNTY ROAD 487
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-2042
Mailing Address - Country:US
Mailing Address - Phone:512-352-7227
Mailing Address - Fax:
Practice Address - Street 1:100 CARLOS PARKER BLVD NW STE 101
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-7059
Practice Address - Country:US
Practice Address - Phone:512-365-2302
Practice Address - Fax:512-352-2052
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist