Healthcare Provider Details

I. General information

NPI: 1235849399
Provider Name (Legal Business Name): LORI ALLEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 TOWN CENTER BLVD
JARRELL TX
76537-4006
US

IV. Provider business mailing address

225 JAKE DR
JARRELL TX
76537-1774
US

V. Phone/Fax

Practice location:
  • Phone: 512-746-0901
  • Fax: 512-598-3779
Mailing address:
  • Phone: 432-770-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number43346
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: