Provider Demographics
NPI:1801497474
Name:LANDWERMEYER, HEATHER DAVIS (PHARM D)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAVIS
Last Name:LANDWERMEYER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 SSW LOOP 323
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-0763
Mailing Address - Country:US
Mailing Address - Phone:903-597-1863
Mailing Address - Fax:
Practice Address - Street 1:2025 SSW LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-0763
Practice Address - Country:US
Practice Address - Phone:903-597-1863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist