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General NPI Number Information
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NPI Number | 1447246442
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Entity Type | Individual
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Provider Name | LINDA CAROL MICK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2005
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 3801 E 42ND ST HEB PHARMACY
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City | ODESSA
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State | TX
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Zip | 79762-5947
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Country | US
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Telephone | 432-362-4555
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Fax | 432-362-4514
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Provider Business Mailing Address
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Address Line | 3801 E 42ND ST HEB PHARMACY
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City | ODESSA
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State | TX
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Zip | 79762-5947
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Country | US
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Telephone | 432-614-4306
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Fax | 432-614-4356
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42585
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License Number State | TX
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