Provider Demographics
NPI:1306173349
Name:LACOMBE, ALYCEN BRENNA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ALYCEN
Middle Name:BRENNA
Last Name:LACOMBE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 CENTRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-546-0476
Mailing Address - Fax:956-546-5583
Practice Address - Street 1:4490 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3240
Practice Address - Country:US
Practice Address - Phone:956-546-0476
Practice Address - Fax:956-546-5583
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist