Provider Demographics
NPI:1124343736
Name:BRYANT, LASHANTA LENELLE (RPH)
Entity type:Individual
Prefix:
First Name:LASHANTA
Middle Name:LENELLE
Last Name:BRYANT
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 1:14402 FM 2100 RD
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-6570
Mailing Address - Country:US
Mailing Address - Phone:281-328-8097
Mailing Address - Fax:281-328-8137
Practice Address - Street 1:14402 FM 2100 RD
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-6570
Practice Address - Country:US
Practice Address - Phone:281-328-8097
Practice Address - Fax:281-328-8137
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist