Provider Demographics
NPI:1245883834
Name:OPERSTENY, LAUREN (PHARMD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:OPERSTENY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 TOBAGO
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-4937
Mailing Address - Country:US
Mailing Address - Phone:281-414-5535
Mailing Address - Fax:
Practice Address - Street 1:4590 KELL BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-4713
Practice Address - Country:US
Practice Address - Phone:940-716-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist