Provider Demographics
NPI:1982158028
Name:DEWITT, JOANNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:DEWITT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:210 W 7TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2903
Mailing Address - Country:US
Mailing Address - Phone:512-893-5000
Mailing Address - Fax:512-229-0795
Practice Address - Street 1:210 W 7TH ST STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2903
Practice Address - Country:US
Practice Address - Phone:512-893-5000
Practice Address - Fax:512-229-0795
Is Sole Proprietor?:No
Enumeration Date:2016-08-06
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist