Healthcare Provider Details

I. General information

NPI: 1104824721
Provider Name (Legal Business Name): MARLA JUNE KNIGHT PHARM.D., C.G.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 S WILLIS ST
ABILENE TX
79605-6650
US

IV. Provider business mailing address

220 HEDGES RD
ABILENE TX
79605-6554
US

V. Phone/Fax

Practice location:
  • Phone: 325-692-6145
  • Fax: 325-691-9907
Mailing address:
  • Phone: 325-692-6145
  • Fax: 325-691-9907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24124
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: