Provider Demographics
NPI:1881295954
Name:TARAWNEH, DANNA
Entity type:Individual
Prefix:
First Name:DANNA
Middle Name:
Last Name:TARAWNEH
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 1:9820 WESTMERE LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-4434
Mailing Address - Country:US
Mailing Address - Phone:817-449-5098
Mailing Address - Fax:
Practice Address - Street 1:6756 W VICKERY BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-9156
Practice Address - Country:US
Practice Address - Phone:817-732-2195
Practice Address - Fax:817-732-2129
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist