Provider Demographics
NPI:1881840478
Name:GARRETT, STEPHANIE DIANE (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DIANE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PHARMD, BCPS
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:601 E 15TH ST
Mailing Address - Street 2:BRACKENRIDGE HOSPITAL - DEPARTMENT OF PHARMACY
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1930
Mailing Address - Country:US
Mailing Address - Phone:512-324-7000
Mailing Address - Fax:512-324-7366
Practice Address - Street 1:601 E 15TH ST
Practice Address - Street 2:BRACKENRIDGE HOSPITAL - DEPARTMENT OF PHARMACY
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1930
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:512-324-7366
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX371061835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist