Provider Demographics
NPI:1841913373
Name:GODWIN, JANINE (PHARMD)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:GODWIN
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 1:6161 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6943
Mailing Address - Country:US
Mailing Address - Phone:214-592-9444
Mailing Address - Fax:214-592-0078
Practice Address - Street 1:6161 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6943
Practice Address - Country:US
Practice Address - Phone:214-592-9444
Practice Address - Fax:214-592-0078
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27876596OtherDRIVERS LICENSE NUMBER