Healthcare Provider Details

I. General information

NPI: 1063985208
Provider Name (Legal Business Name): DARLA ANN SHLENSKY R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HALL RD
SEAGOVILLE TX
75159-2916
US

IV. Provider business mailing address

112 HALL RD
SEAGOVILLE TX
75159-2916
US

V. Phone/Fax

Practice location:
  • Phone: 972-287-7070
  • Fax: 972-287-8199
Mailing address:
  • Phone: 972-287-7070
  • Fax: 972-287-8199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22673
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: