Provider Demographics
NPI:1619205630
Name:SCOTT, PENNY C (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PENNY
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 ROCK PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5917
Mailing Address - Country:US
Mailing Address - Phone:979-764-1805
Mailing Address - Fax:979-764-1851
Practice Address - Street 1:1751 ROCK PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5917
Practice Address - Country:US
Practice Address - Phone:979-764-1805
Practice Address - Fax:979-764-1851
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist