Provider Demographics
NPI:1528387123
Name:WALKER, PAULA JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:WALKER
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 1:1346 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-4854
Mailing Address - Country:US
Mailing Address - Phone:817-251-9411
Mailing Address - Fax:
Practice Address - Street 1:8955 N TARRANT PKWY
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8466
Practice Address - Country:US
Practice Address - Phone:817-428-2585
Practice Address - Fax:817-428-3283
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist