Provider Demographics
NPI:1982603197
Name:KRETSCHMER, DIANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:KRETSCHMER
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 1:1910 N GENOA AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-9640
Mailing Address - Country:US
Mailing Address - Phone:806-743-7710
Mailing Address - Fax:806-743-7693
Practice Address - Street 1:6630 QUAKER AVE
Practice Address - Street 2:SUITE G
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5900
Practice Address - Country:US
Practice Address - Phone:806-743-7710
Practice Address - Fax:806-743-7693
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist