Provider Demographics
NPI:1851991277
Name:CARROLL, YEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:YEN
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4925 SCARLETT OAK DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-4603
Mailing Address - Country:US
Mailing Address - Phone:803-422-1989
Mailing Address - Fax:
Practice Address - Street 1:5501 SHERWOOD WAY
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-9738
Practice Address - Country:US
Practice Address - Phone:325-942-7682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist