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NPI Code Detail

MEDICARE: LISA C. CROWDUS REGISTERED PHARMACIS

MEDICARE: LISA C. CROWDUS REGISTERED PHARMACIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist27388TX

General Provider Information

NPI Number : 1033436027
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA C. CROWDUS REGISTERED PHARMACIS
Provider Business Mailing Address
First Line : 3750 GATTIS SCHOOL RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-4642
Country : US
Telephone Number : 512-341-3771
Fax Number : 512-341-0947
Provider Business Practice Location Address
First Line : 3750 GATTIS SCHOOL RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-4642
Country : US
Telephone Number : 512-341-3771
Fax Number : 512-341-0947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 04/29/2010

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