Provider Demographics
NPI:1841586021
Name:WALTON, DANA RENE' (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:RENE'
Last Name:WALTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7302 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1423
Mailing Address - Country:US
Mailing Address - Phone:806-748-6456
Mailing Address - Fax:806-748-6456
Practice Address - Street 1:7302 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1423
Practice Address - Country:US
Practice Address - Phone:806-748-6456
Practice Address - Fax:806-748-6456
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist