Healthcare Provider Details

I. General information

NPI: 1033752878
Provider Name (Legal Business Name): SHARON MARIE LANCE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON MARIE LANCE

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W WALLACE ST
SAN SABA TX
76877-4433
US

IV. Provider business mailing address

401 W WALLACE ST
SAN SABA TX
76877-4433
US

V. Phone/Fax

Practice location:
  • Phone: 325-372-3033
  • Fax: 325-372-5961
Mailing address:
  • Phone: 325-372-3033
  • Fax: 325-372-5961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28611
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: