Provider Demographics
NPI:1982842225
Name:DURDEN, LISA DARLENE (RPH)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:DARLENE
Last Name:DURDEN
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 1:3044 ANTOINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7053
Mailing Address - Country:US
Mailing Address - Phone:713-681-5483
Mailing Address - Fax:713-681-5489
Practice Address - Street 1:3044 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7053
Practice Address - Country:US
Practice Address - Phone:713-681-5483
Practice Address - Fax:713-681-5489
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist