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General NPI Number Information
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NPI Number | 1447369467
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Entity Type | Individual
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Provider Name | SHANNON PASTERNAK RPH
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 E 9TH ST
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City | BONHAM
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State | TX
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Zip | 75418-4059
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Country | US
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Telephone | 903-583-6753
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Fax |
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Provider Business Mailing Address
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Address Line | 3610 BROWNWOOD DR
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City | PARIS
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State | TX
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Zip | 75462-8100
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 33530
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License Number State | TX
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