Provider Demographics
NPI:1306175047
Name:DANNER, GAIL LENORE
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:LENORE
Last Name:DANNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 FAIRMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4219
Mailing Address - Country:US
Mailing Address - Phone:281-998-7416
Mailing Address - Fax:
Practice Address - Street 1:390 EDGEBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-2102
Practice Address - Country:US
Practice Address - Phone:713-943-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1306175047Medicaid