Provider Demographics
NPI:1639212277
Name:GARTENHAUS, JANE FRANCES (RPH)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:FRANCES
Last Name:GARTENHAUS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:FRANCES
Other - Last Name:GILMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 S WEST ST
Mailing Address - Street 2:BOX 19329
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76019-0001
Mailing Address - Country:US
Mailing Address - Phone:817-272-2770
Mailing Address - Fax:817-272-7192
Practice Address - Street 1:605 S WEST ST
Practice Address - Street 2:BOX 19329
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76019-0001
Practice Address - Country:US
Practice Address - Phone:817-272-2770
Practice Address - Fax:817-272-7192
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26875183500000X
IN26014028A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26014028AOtherPHARMACIST LICENSE
TX26875OtherPHARMACIST LICENSE