Provider Demographics
NPI:1265057517
Name:YACINTHE, LAURA THERESA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:THERESA
Last Name:YACINTHE
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 1:10800 TALL OAK TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1536
Mailing Address - Country:US
Mailing Address - Phone:516-425-8543
Mailing Address - Fax:
Practice Address - Street 1:119 ED SCHMIDT BLVD
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5557
Practice Address - Country:US
Practice Address - Phone:516-425-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist