Provider Demographics
NPI:1508467150
Name:WIMBERLY, CHELSEA LATON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LATON
Last Name:WIMBERLY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 N TEXANA ST
Mailing Address - Street 2:
Mailing Address - City:HALLETTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77964-2036
Mailing Address - Country:US
Mailing Address - Phone:361-798-4379
Mailing Address - Fax:361-798-4592
Practice Address - Street 1:1506 N TEXANA ST
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-2036
Practice Address - Country:US
Practice Address - Phone:361-798-4379
Practice Address - Fax:361-798-4592
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist