Healthcare Provider Details

I. General information

NPI: 1265789283
Provider Name (Legal Business Name): ASHLEY LYNN BUZARD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 KELLER PKWY
KELLER TX
76248-3619
US

IV. Provider business mailing address

800 E ASH LN APT 823
EULESS TX
76039-4784
US

V. Phone/Fax

Practice location:
  • Phone: 817-431-5305
  • Fax:
Mailing address:
  • Phone: 801-631-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number51559
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: