Provider Demographics
NPI:1588979165
Name:DANIELL, DENA SHEA (RPH)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:SHEA
Last Name:DANIELL
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 1:538 S COUNTY ROAD 263
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:77434-7191
Mailing Address - Country:US
Mailing Address - Phone:979-234-5737
Mailing Address - Fax:
Practice Address - Street 1:2700 7TH ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-5305
Practice Address - Country:US
Practice Address - Phone:979-245-1881
Practice Address - Fax:979-244-1945
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist