Provider Demographics
NPI:1659609691
Name:NEWMAN, TONI BYRD
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:BYRD
Last Name:NEWMAN
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:SR12225 HWY 6
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545
Mailing Address - Country:US
Mailing Address - Phone:281-431-4248
Mailing Address - Fax:
Practice Address - Street 1:12225 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8805
Practice Address - Country:US
Practice Address - Phone:281-431-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist