Provider Demographics
NPI:1811527302
Name:LAUBER, STACEY ATTAWAY (RPH)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:ATTAWAY
Last Name:LAUBER
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 1:5101 W SUBLETT RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1178
Mailing Address - Country:US
Mailing Address - Phone:817-516-5763
Mailing Address - Fax:817-516-3766
Practice Address - Street 1:5101 W SUBLETT RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1178
Practice Address - Country:US
Practice Address - Phone:817-516-5763
Practice Address - Fax:817-516-3766
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327581835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist