Provider Demographics
NPI:1154662906
Name:OLFERS, JENA (PHARMD)
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:OLFERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 TURTLE DOVE DR
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3335
Mailing Address - Country:US
Mailing Address - Phone:210-831-9400
Mailing Address - Fax:
Practice Address - Street 1:1368 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5131
Practice Address - Country:US
Practice Address - Phone:830-379-0160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist