Provider Demographics
NPI:1952745853
Name:BALFOUR, DANYELL M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANYELL
Middle Name:M
Last Name:BALFOUR
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 1:12901 N IH 35 STE 3-300
Mailing Address - Street 2:T1817
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1020
Mailing Address - Country:US
Mailing Address - Phone:512-651-0609
Mailing Address - Fax:
Practice Address - Street 1:12901 N IH 35 STE 3-300
Practice Address - Street 2:T1817
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1020
Practice Address - Country:US
Practice Address - Phone:512-651-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist