Provider Demographics
NPI:1932856572
Name:MAKONEN, HERUTH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HERUTH
Middle Name:
Last Name:MAKONEN
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 1:25000 HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-5478
Mailing Address - Country:US
Mailing Address - Phone:832-231-0591
Mailing Address - Fax:
Practice Address - Street 1:1201 N MECHANIC ST
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-2613
Practice Address - Country:US
Practice Address - Phone:979-942-3687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist