Provider Demographics
NPI:1588188452
Name:STEPHENS, KARMEN LEE ANN (PHARMD, BCGP)
Entity type:Individual
Prefix:DR
First Name:KARMEN
Middle Name:LEE ANN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:DR
Other - First Name:KARMEN
Other - Middle Name:LEE ANN
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1010 E ARAPAHO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2362
Mailing Address - Country:US
Mailing Address - Phone:833-444-8840
Mailing Address - Fax:
Practice Address - Street 1:1010 E ARAPAHO RD STE 102
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081
Practice Address - Country:US
Practice Address - Phone:806-676-8382
Practice Address - Fax:214-614-4740
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91072151835G0303X
TX48764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN124015OtherPHARMACIST LICENSE
OK17417OtherPHARMACIST LICENSE
TX48764OtherPHARMACIST LICENSE
VA0202217182OtherPHARMACIST LICENSE
WI20723-40OtherPHARMACIST LICENSE
PARP453101OtherPHARMACIST LICENSE
IL051301645OtherPHARMACIST LICENSE
MO2012036677OtherPHARMACIST LICENSE