Provider Demographics
NPI:1063558765
Name:ARB, WHITNEY DENISE (RPH)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:DENISE
Last Name:ARB
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 CRATER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-4452
Mailing Address - Country:US
Mailing Address - Phone:817-428-0518
Mailing Address - Fax:
Practice Address - Street 1:15001 TRINITY BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76155-2647
Practice Address - Country:US
Practice Address - Phone:800-455-8352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX39827OtherPHARMACIST LICENSE
MO044453OtherPHARMACIST LICENSE