Provider Demographics
NPI:1184945487
Name:ISAAC, ANITA MARIE (RPH)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:ISAAC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:MARIE
Other - Last Name:DANNELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 FM 685
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8045
Mailing Address - Country:US
Mailing Address - Phone:512-251-9037
Mailing Address - Fax:512-251-9564
Practice Address - Street 1:201 FM 685
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-8045
Practice Address - Country:US
Practice Address - Phone:512-251-9037
Practice Address - Fax:512-251-9564
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist