Provider Demographics
NPI:1215523618
Name:MCCALEB, DENISE E (PHARMACIST)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:E
Last Name:MCCALEB
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21005 EVA ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-1897
Mailing Address - Country:US
Mailing Address - Phone:936-597-8002
Mailing Address - Fax:936-597-8230
Practice Address - Street 1:21005 EVA ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-1897
Practice Address - Country:US
Practice Address - Phone:936-597-8002
Practice Address - Fax:936-597-8230
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist