Provider Demographics
NPI:1205237633
Name:KLOESEL, ANJANETTE BRIANA (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:ANJANETTE
Middle Name:BRIANA
Last Name:KLOESEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 N NAVARRO ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1563
Mailing Address - Country:US
Mailing Address - Phone:361-574-1105
Mailing Address - Fax:
Practice Address - Street 1:9005 N NAVARRO ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1563
Practice Address - Country:US
Practice Address - Phone:361-574-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist