Provider Demographics
NPI:1184213233
Name:RODGERS, DESHAWN (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:DESHAWN
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19529 NORTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3869
Mailing Address - Country:US
Mailing Address - Phone:281-312-1364
Mailing Address - Fax:
Practice Address - Street 1:19529 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3869
Practice Address - Country:US
Practice Address - Phone:281-312-1364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician