Provider Demographics
NPI:1811224553
Name:HODNETT, VICKI JO (PHARM D)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:JO
Last Name:HODNETT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5921 HILLSIDE RD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6294
Mailing Address - Country:US
Mailing Address - Phone:806-463-1057
Mailing Address - Fax:806-463-3256
Practice Address - Street 1:5921 HILLSIDE RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6294
Practice Address - Country:US
Practice Address - Phone:806-463-1057
Practice Address - Fax:806-463-3256
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist