Provider Demographics
NPI:1649004094
Name:GOBER, RENEE (PHARMD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:GOBER
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 1:801 N 3RD ST E
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-6117
Mailing Address - Country:US
Mailing Address - Phone:940-256-3228
Mailing Address - Fax:
Practice Address - Street 1:1 AVENUE N
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:TX
Practice Address - Zip Code:79521-5415
Practice Address - Country:US
Practice Address - Phone:940-864-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist