Provider Demographics
NPI:1528673183
Name:BUTLER, NANCY LISSETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LISSETH
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 RESEARCH BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5712
Mailing Address - Country:US
Mailing Address - Phone:512-634-2252
Mailing Address - Fax:
Practice Address - Street 1:10401 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5712
Practice Address - Country:US
Practice Address - Phone:512-634-2252
Practice Address - Fax:512-634-2271
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist