Provider Demographics
NPI:1215998422
Name:LEE, ALMA RASCO (RPH)
Entity type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:RASCO
Last Name:LEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:ALMA
Other - Middle Name:JEAN
Other - Last Name:RASCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2158 PARADISE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-7908
Mailing Address - Country:US
Mailing Address - Phone:512-246-0428
Mailing Address - Fax:
Practice Address - Street 1:12647 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6345
Practice Address - Country:US
Practice Address - Phone:800-325-3982
Practice Address - Fax:877-685-9866
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist