Provider Demographics
NPI:1467067926
Name:CREAN, KATHRYN LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LEIGH
Last Name:CREAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LEIGH
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:224 TRELLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3754
Mailing Address - Country:US
Mailing Address - Phone:210-835-7292
Mailing Address - Fax:
Practice Address - Street 1:302 GATEWAY N
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6317
Practice Address - Country:US
Practice Address - Phone:830-693-2374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist