Provider Demographics
NPI:1790069888
Name:HALE, BRIANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:HALE
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 1:1828 TEXOMA PKWY
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2616
Mailing Address - Country:US
Mailing Address - Phone:903-868-2620
Mailing Address - Fax:
Practice Address - Street 1:1828 TEXOMA PKWY
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2616
Practice Address - Country:US
Practice Address - Phone:903-868-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210183183500000X
TX51168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist