Healthcare Provider Details

I. General information

NPI: 1952901134
Provider Name (Legal Business Name): JENNIFER JEANEAN RAGSDALE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER BLANK RAGSDALE RPH

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 S COLORADO ST
LOCKHART TX
78644-3949
US

IV. Provider business mailing address

321 LEISUREWOODS DR
BUDA TX
78610-2422
US

V. Phone/Fax

Practice location:
  • Phone: 512-398-2364
  • Fax:
Mailing address:
  • Phone: 512-848-0913
  • Fax: 512-295-5034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27588
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: