Provider Demographics
NPI:1588110142
Name:FARMER, TARA ALYSE (PHARMD)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:ALYSE
Last Name:FARMER
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 W SHANDON AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-6328
Mailing Address - Country:US
Mailing Address - Phone:325-895-5643
Mailing Address - Fax:
Practice Address - Street 1:1101 E FRONT ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-4934
Practice Address - Country:US
Practice Address - Phone:432-686-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist