Provider Demographics
NPI:1609060888
Name:FIELDER, MARLA LANICE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MARLA
Middle Name:LANICE
Last Name:FIELDER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S LOOP 336 W
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3306
Mailing Address - Country:US
Mailing Address - Phone:936-756-5574
Mailing Address - Fax:936-441-5533
Practice Address - Street 1:220 S LOOP 336 W
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3306
Practice Address - Country:US
Practice Address - Phone:936-756-5574
Practice Address - Fax:936-441-5533
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist