Jackie Lynn Weaver is a Pharmacist in Tyler, Texas. Jackie Lynn Weaver practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Jackie Lynn Weaver is 1720072523. The last update date is 2017-01-19.
Jackie Lynn Weaver's current location address is 2726 W Gentry Pkwy, Tyler, Texas. You can contact this provider via phone number 9035932533 and fax number 9035932555. The mailing address for Jackie Lynn Weaver is 2726 W Gentry Pkwy, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie Lynn Weaver |
|---|---|
| Address | 2726 W Gentry Pkwy, Tyler, Texas |
| Phone Number | 9035932533 |
| Fax Number | 9035932555 |
| Sole Proprietor | Y |
| Credentials | DC, PHARM |
NPI Number Detail
| NPI Number | 1720072523 |
|---|---|
| Provider Enumeration Date | 2005-09-07 |
| Last Updated Date | 2017-01-19 |
Provider Mailing Address Detail
| Address | 2726 W Gentry Pkwy |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757021635 |
| Phone Number | 9035932533 |
| Fax Number | 9035932555 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 48560 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1665101 | TX | -- | |
| 8K1680 | BLUE CROSS |
Post Comment/ Review Below
What is the Jackie Lynn Weaver's 1720072523?
The Jackie Lynn Weaver's NPI (National Provider Identifier) Number is 1720072523. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jackie Lynn Weaver's physical address?
The Jackie Lynn Weaver is physically located at 2726 W Gentry Pkwy, in the city of Tyler, TX, with the postal code 757021635.
What is Jackie Lynn Weaver's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jackie Lynn Weaver's specialized field of practice is Pharmacist, and the corresponding taxonomy code that categorizes this area of specialization is 183500000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1720072523 to Jackie Lynn Weaver?
The Centers for Medicare & Medicaid Services assigned the 1720072523 to Jackie Lynn Weaver on 2005-09-07.
When was the information related to Jackie Lynn Weaver most recently updated or refreshed?
The details pertaining to the Jackie Lynn Weaver, including its address, specialty, and other relevant information, were last updated or refreshed on 2017-01-19.
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