Provider Demographics
NPI:1477809630
Name:DENNIS, RESHAWN Y (RPH)
Entity type:Individual
Prefix:MRS
First Name:RESHAWN
Middle Name:Y
Last Name:DENNIS
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 1:3215 CRESTBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-5324
Mailing Address - Country:US
Mailing Address - Phone:832-922-1109
Mailing Address - Fax:
Practice Address - Street 1:3605 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4617
Practice Address - Country:US
Practice Address - Phone:409-832-7474
Practice Address - Fax:409-832-7863
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist