Provider Demographics
NPI:1417239252
Name:HODNETT, LINDA (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HODNETT
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 1:2500 STATE HIGHWAY 121
Mailing Address - Street 2:APT 1438
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-6002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4403 COLLEYVILLE BLVD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3928
Practice Address - Country:US
Practice Address - Phone:817-514-9458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist