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General NPI Number Information
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NPI Number | 1588036941
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Entity Type | Individual
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Provider Name | CARLA SIMARD PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 105 WILDWOOD DR STE 101
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City | GEORGETOWN
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State | TX
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Zip | 78633-1344
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Country | US
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Telephone | 512-819-9848
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Fax |
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Provider Business Mailing Address
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Address Line | 6505 TANZANITE DR
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City | KILLEEN
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State | TX
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Zip | 76542-3361
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Country | US
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Telephone | 254-251-7681
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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 | 55095
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License Number State | TX
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