Provider Demographics
NPI:1487251732
Name:KLEINSCHMIDT, RPH, ANNA MARIE (REGISTERED PHARMACIS)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:KLEINSCHMIDT, RPH
Suffix:
Gender:F
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3596 COUNTY ROAD 405
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:78947-4939
Mailing Address - Country:US
Mailing Address - Phone:979-542-7925
Mailing Address - Fax:
Practice Address - Street 1:513 E AUSTIN ST
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-3305
Practice Address - Country:US
Practice Address - Phone:979-542-3308
Practice Address - Fax:979-542-1658
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX29524OtherTEXAS STATE BOARD OF PHARMACY