Healthcare Provider Details

I. General information

NPI: 1093870230
Provider Name (Legal Business Name): KELLI RENEE HILL PHARMD, BCOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLI RENEE MCCLURE PHARMD, BCOP

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 WALNUT HILL LN STE 700
DALLAS TX
75231-4403
US

IV. Provider business mailing address

8220 WALNUT HILL LN STE 700
DALLAS TX
75231-4403
US

V. Phone/Fax

Practice location:
  • Phone: 214-265-2066
  • Fax: 214-346-3520
Mailing address:
  • Phone: 214-265-2066
  • Fax: 214-346-3520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number37065
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: