Healthcare Provider Details

I. General information

NPI: 1043221716
Provider Name (Legal Business Name): ALICE KATHLEEN LYNCH PHARMD, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 1ST ST
TEMPLE TX
76504-7451
US

IV. Provider business mailing address

6007 HIGHLANDALE DR
AUSTIN TX
78731-4003
US

V. Phone/Fax

Practice location:
  • Phone: 254-743-0019
  • Fax: 254-743-0020
Mailing address:
  • Phone: 512-407-9034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number28865
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: