Provider Demographics
NPI:1689431595
Name:DONOVAN, LEAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 LAUREL HILL LN
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4151
Mailing Address - Country:US
Mailing Address - Phone:214-384-0741
Mailing Address - Fax:
Practice Address - Street 1:1950 N GOLIAD ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-7206
Practice Address - Country:US
Practice Address - Phone:469-651-6026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist