Provider Demographics
NPI:1518248046
Name:BOONE, CHRISTINE CARRIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:CARRIE
Last Name:BOONE
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 1:3104 LOMBARDI WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4301
Mailing Address - Country:US
Mailing Address - Phone:512-330-4898
Mailing Address - Fax:
Practice Address - Street 1:201 FM 685
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-8045
Practice Address - Country:US
Practice Address - Phone:512-251-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist