Provider Demographics
NPI:1609497114
Name:SETTERBO, NAEDA MARIE
Entity Type:Individual
Prefix:
First Name:NAEDA
Middle Name:MARIE
Last Name:SETTERBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2735
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0051
Mailing Address - Country:US
Mailing Address - Phone:512-256-6979
Mailing Address - Fax:512-256-6938
Practice Address - Street 1:4515 SETON CENTER PKWY STE 175
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5730
Practice Address - Country:US
Practice Address - Phone:512-256-6979
Practice Address - Fax:512-256-6938
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist