Provider Demographics
NPI:1295336469
Name:KRAWCZYNSKI, LISA CHRISTINA (RPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CHRISTINA
Last Name:KRAWCZYNSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CHACHALACA DR
Mailing Address - Street 2:
Mailing Address - City:BAYVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78566-4476
Mailing Address - Country:US
Mailing Address - Phone:956-343-8684
Mailing Address - Fax:
Practice Address - Street 1:WALMART SUPERCENTER
Practice Address - Street 2:1004 W. OCEAN BLVD.
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566
Practice Address - Country:US
Practice Address - Phone:956-233-1822
Practice Address - Fax:956-233-1798
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist