Provider Demographics
NPI:1528510716
Name:MCCUIN, PATRICIA A (RPH)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:MCCUIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2104
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-0104
Mailing Address - Country:US
Mailing Address - Phone:254-699-0624
Mailing Address - Fax:254-669-6170
Practice Address - Street 1:400 E FM 2410 RD
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-5712
Practice Address - Country:US
Practice Address - Phone:254-680-3499
Practice Address - Fax:254-680-7539
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX387521835P1200X, 2083P0901X, 1835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1528510716Other1528510716
TX38752OtherPHARMACY