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NPI Code Detail

MEDICARE: ANGELA M KORANEK PHARM.D.

MEDICARE: ANGELA M KORANEK PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist47383TX

General Provider Information

NPI Number : 1376773721
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA M KORANEK PHARM.D.
Provider Business Mailing Address
First Line : 2400 AVENUE I
Second Line :
City : HUNTSVILLE
State : TX
Zip : 77340-5830
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2400 AVENUE I
Second Line :
City : HUNTSVILLE
State : TX
Zip : 77340-5830
Country : US
Telephone Number : 936-437-5377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2009
Last Update Date : 07/25/2014

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