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General NPI Number Information
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NPI Number | 1043966989
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Entity Type | Individual
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Provider Name | DEIDRE LYNN DANIELS PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 8989 FOREST LN STE 138
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City | DALLAS
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State | TX
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Zip | 75243-4137
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Country | US
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Telephone | 469-839-3444
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Fax | 877-848-1331
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Provider Business Mailing Address
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Address Line | 8700 CLEVELAND AVE
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City | KANSAS CITY
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State | KS
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Zip | 66109-1927
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Country | US
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Telephone | 870-514-6389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 49651
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 2021046245
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 1-14725
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PD11131
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License Number State | AR
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