Provider Demographics
NPI:1942800792
Name:STARNES, KENNA B (RPH)
Entity Type:Individual
Prefix:
First Name:KENNA
Middle Name:B
Last Name:STARNES
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 1:3921 BENBROOK HWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7895
Mailing Address - Country:US
Mailing Address - Phone:817-738-2135
Mailing Address - Fax:817-763-8784
Practice Address - Street 1:3921 BENBROOK HWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7895
Practice Address - Country:US
Practice Address - Phone:817-738-2135
Practice Address - Fax:817-763-8784
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist