Provider Demographics
NPI:1609488360
Name:TIMAEUS, LINDA KAY (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:TIMAEUS
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 1:685 GOODHUE RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6223
Mailing Address - Country:US
Mailing Address - Phone:409-673-9898
Mailing Address - Fax:
Practice Address - Street 1:202 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7345
Practice Address - Country:US
Practice Address - Phone:406-755-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist