Provider Demographics
NPI:1316312523
Name:BARNETT, JENNIFER (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BARNETT
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 1:2808 CHATSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-3472
Mailing Address - Country:US
Mailing Address - Phone:806-584-3124
Mailing Address - Fax:
Practice Address - Street 1:1325 PENNSYLVANIA AVE
Practice Address - Street 2:STE #60
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2158
Practice Address - Country:US
Practice Address - Phone:817-882-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist