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General NPI Number Information
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NPI Number | 1548860935
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Entity Type | Individual
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Provider Name | KIM DEWBRE RPH
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Gender | Female
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 407 E HIGHWAY 114
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City | LEVELLAND
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State | TX
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Zip | 79336-2629
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Country | US
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Telephone | 806-894-7583
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Fax |
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Provider Business Mailing Address
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Address Line | 7222 FM 1729
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City | SHALLOWATER
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State | TX
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Zip | 79363-3308
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Country | US
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Telephone | 432-425-7105
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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 | 29703
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License Number State | TX
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