Provider Demographics
NPI:1952438012
Name:REEVES, SUSAN L (RPH)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:REEVES
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 1:1602 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-7329
Mailing Address - Country:US
Mailing Address - Phone:972-242-7431
Mailing Address - Fax:972-254-3228
Practice Address - Street 1:2001 N MACARTHUR BLVD STE 630
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2282
Practice Address - Country:US
Practice Address - Phone:972-256-3537
Practice Address - Fax:972-254-3228
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304601835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology