Provider Demographics
NPI:1023303153
Name:RONALDER, CATHERINE L (RPH)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:L
Last Name:RONALDER
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 1:200 NW JOHN JONES DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-5615
Mailing Address - Country:US
Mailing Address - Phone:817-302-0059
Mailing Address - Fax:817-302-0059
Practice Address - Street 1:200 NW JOHN JONES DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-5615
Practice Address - Country:US
Practice Address - Phone:817-302-0059
Practice Address - Fax:817-302-0059
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist