Provider Demographics
NPI:1780979229
Name:FITZPATRICK, TRICIA L
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:L
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 STATE HIGHWAY 121
Mailing Address - Street 2:T-2142
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2917
Mailing Address - Country:US
Mailing Address - Phone:972-439-3398
Mailing Address - Fax:972-439-3398
Practice Address - Street 1:8900 STATE HIGHWAY 121
Practice Address - Street 2:T-2142
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2917
Practice Address - Country:US
Practice Address - Phone:972-439-3398
Practice Address - Fax:972-439-3398
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist