Provider Demographics
NPI:1982329991
Name:CARRASCO, ANNA (CPHT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CARRASCO
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 BUNCHE AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5786
Mailing Address - Country:US
Mailing Address - Phone:432-940-9563
Mailing Address - Fax:
Practice Address - Street 1:319 GOLDER AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5009
Practice Address - Country:US
Practice Address - Phone:432-640-1357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician