Provider Demographics
NPI:1477889046
Name:ODROBINA, STEPHANIE LAUREN (RPH)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:ODROBINA
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 1:2140 E CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2027
Mailing Address - Country:US
Mailing Address - Phone:972-889-9102
Mailing Address - Fax:972-889-9109
Practice Address - Street 1:2140 E CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2027
Practice Address - Country:US
Practice Address - Phone:972-889-9102
Practice Address - Fax:972-889-9109
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist