Provider Demographics
NPI:1891126926
Name:TRAVIS, ALANNA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ALANNA
Middle Name:
Last Name:TRAVIS
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 1:3980 STATE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8823
Mailing Address - Country:US
Mailing Address - Phone:940-591-3299
Mailing Address - Fax:
Practice Address - Street 1:3980 STATE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8823
Practice Address - Country:US
Practice Address - Phone:940-591-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX473901835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX47390OtherPHARMACY LICENSE