Provider Demographics
NPI:1629352158
Name:KNOTTS, KAREN R (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:KNOTTS
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 1:1155 UNION CIR # 305160
Mailing Address - Street 2:SHWC PHARMACY
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76203-5017
Mailing Address - Country:US
Mailing Address - Phone:940-565-2790
Mailing Address - Fax:940-565-3150
Practice Address - Street 1:1800 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-565-2790
Practice Address - Fax:940-565-3150
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist