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NPI Code Detail

MEDICARE: DR. GLENDA JEWEL HART PHARM.D., MBA

MEDICARE:  DR. GLENDA JEWEL HART  PHARM.D., MBA
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
1183500000XPharmacist53388TX

General Provider Information

NPI Number : 1376985267
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLENDA JEWEL HART PHARM.D., MBA
Provider Business Mailing Address
First Line : 2410 FOREST PARK BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-1702
Country : US
Telephone Number : 682-250-3116
Fax Number : 817-549-7739
Provider Business Practice Location Address
First Line : 2410 FOREST PARK BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-1702
Country : US
Telephone Number : 682-250-3116
Fax Number : 817-549-7739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2013
Last Update Date : 10/05/2022

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Directions to “ DR. GLENDA JEWEL HART PHARM.D., MBA” Practice Location

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