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General NPI Number Information
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NPI Number | 1760039168
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Entity Type | Individual
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Provider Name | JENDY THOMAS RPH
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 3121 SUNSET DR
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City | SAN ANGELO
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State | TX
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Zip | 76904-6501
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Country | US
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Telephone | 325-942-6658
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Fax | 325-949-6654
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Provider Business Mailing Address
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Address Line | PO BOX 61931
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City | SAN ANGELO
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State | TX
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Zip | 76906-1931
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Country | US
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Telephone | 361-318-0812
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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 | 36782
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License Number State | TX
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