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General NPI Number Information
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NPI Number | 1831191311
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Entity Type | Individual
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Provider Name | CYNTHIA G DERDEN PHARM D
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Gender | Female
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Dates
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Enumeration Date | 08/13/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6850 N SHILOH RD
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City | GARLAND
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State | TX
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Zip | 75044-2912
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Country | US
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Telephone | 972-496-4403
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Fax | 972-496-4303
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Provider Business Mailing Address
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Address Line | 2990 GREENFIELD DR
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City | RICHARDSON
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State | TX
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Zip | 75082-3648
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Country | US
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Telephone | 972-231-2792
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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 | 42394
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License Number State | TX
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